Department of Medicine, Division of Cardiology, University of California San Diego, San Diego, California.
Department of Cardiology, Clinical Sciences, Lund University and Skane University Hospital, Lund, Sweden.
Heart Lung. 2019 Mar-Apr;48(2):85-89. doi: 10.1016/j.hrtlng.2018.08.011. Epub 2018 Sep 15.
The Stanford integrated psychosocial assessment for transplantation (SIPAT) is a validated psychosocial evaluation tool in the transplant population.
We evaluated SIPAT in predicting post-left ventricular assist device (LVAD) outcomes, including cumulative re-admissions, driveline infections, pump malfunction, pump thrombosis, gastrointestinal bleeding, major bleeding, stroke and right ventricular failure.
This retrospective study included 50 LVAD patients at an academic institution in the United States who had a pre-implant SIPAT score during the years 2015-2017. Patients were split into two groups based on SIPAT score, separating a "excellent"/"good" from a "minimally acceptable"/"poor" candidate. Poisson regression, using SIPAT as both a categorical and continuous variable, was used to compare the incidence rates of the primary outcome of cumulative re-admissions and secondary outcomes of LVAD complications.
The patient cohort was predominantly male 93.5% vs 89.4% (p = 0.629) with a median age of 67.0 vs 58.0 years (p = 0.037), planned destination therapy 48.4% vs 68.4% (p = 0.242) and median LVAD follow-up time of 241 vs 379 days (p = 0.10) in the low- and high- SIPAT groups, respectively. SIPAT was not a significant predictor for cumulative re-admissions, but there was an association between higher SIPAT scores and major bleeding.
In this single-center retrospective study, SIPAT did not predict cumulative re-admissions. Further study is required to validate SIPAT before clinical implementation.
斯坦福综合移植心理评估（SIPAT）是移植人群中经过验证的心理社会评估工具。
我们评估了 SIPAT 在预测左心室辅助装置（LVAD）后结果中的作用，包括累积再入院、导线感染、泵故障、泵血栓形成、胃肠道出血、大出血、中风和右心衰竭。
这项回顾性研究包括美国一家学术机构的 50 名 LVAD 患者，他们在 2015-2017 年期间进行了植入前 SIPAT 评分。患者根据 SIPAT 评分分为两组，将“优秀”/“良好”与“勉强合格”/“差”的候选者分开。使用 Poisson 回归，将 SIPAT 作为分类和连续变量，比较累积再入院的主要结果和 LVAD 并发症的次要结果的发生率。
患者队列主要为男性（93.5%比 89.4%，p=0.629），中位年龄为 67.0 岁比 58.0 岁（p=0.037），计划的治疗终点为 48.4%比 68.4%（p=0.242），低和高 SIPAT 组的 LVAD 中位随访时间分别为 241 天和 379 天（p=0.10）。SIPAT 不是累积再入院的显著预测因素，但 SIPAT 评分较高与大出血有关。
在这项单中心回顾性研究中，SIPAT 不能预测累积再入院。在临床实施之前，需要进一步研究来验证 SIPAT。
