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永久性左心室辅助装置植入后的照顾者状况及结局

Caregiver status and outcomes after durable left ventricular assist device implantation.

作者信息

Koeckert Michael, Vining Patrick, Reyentovich Alex, Katz Stuart D, DeAnda Abe, Philipson Stefanie, Balsam Leora B

机构信息

Department of Cardiothoracic Surgery, NYU-Langone Medical Center, New York, NY, USA.

Division of Cardiology, NYU-Langone Medical Center, New York, NY, USA.

出版信息

Heart Lung. 2017 Mar-Apr;46(2):74-78. doi: 10.1016/j.hrtlng.2016.12.001. Epub 2017 Jan 2.

Abstract

OBJECTIVES

To determine the relationship between caregiver status and outcomes after durable left ventricular assist device (LVAD) implantation.

BACKGROUND

The absence of a caregiver is a relative contraindication to durable LVAD support.

METHODS

Forty-three patients that underwent primary LVAD implantation were divided into three groups: those with caregivers that retained their roles for the duration of LVAD support (CG group), those with caregivers that resigned their roles (CG-QUIT group), and those implanted without an assigned caregiver (No-CG group). Group-specific characteristics and post-implant outcomes were compared.

RESULTS

In the CG-QUIT group, caregivers did not live in the same home (0.0% vs. 80.6% of CG group) and none were spouses (0.0% vs. 64.5% for CG group). Thirty-day readmission rate was highest in the CG-QUIT group (83.3% vs. 25.8% in CG group and 16.7% in No-CG group).

CONCLUSIONS

Caregiver relationships were more likely to be maintained for the duration of LVAD support when the caregiver was a spouse and resided in the same home as the patient. Carefully selected patients implanted without a designated caregiver had comparable outcomes to those who retained their original caregiver.

摘要

目的

确定在植入耐用型左心室辅助装置(LVAD)后,照料者状况与治疗结果之间的关系。

背景

缺乏照料者是耐用型LVAD支持的相对禁忌症。

方法

43例行初次LVAD植入的患者被分为三组:在LVAD支持期间照料者仍履行职责的患者(CG组)、照料者辞去职责的患者(CG-QUIT组)以及未安排照料者而植入LVAD的患者(无CG组)。比较各组的特定特征和植入后的结果。

结果

在CG-QUIT组中,照料者与患者不住在同一家庭(0.0%对比CG组的80.6%),且均非配偶(0.0%对比CG组的64.5%)。CG-QUIT组的30天再入院率最高(83.3%对比CG组的25.8%和无CG组的16.7%)。

结论

当照料者为配偶且与患者同住时,在LVAD支持期间照料者关系更有可能得以维持。精心挑选的未指定照料者而植入LVAD的患者与保留原照料者的患者有相似的治疗结果。

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