From the Faculty of Medicine, Institute of Nursing Science, University of Freiburg, Freiburg, Germany.
German Heart Center Berlin, Freiburg, Germany.
ASAIO J. 2024 May 1;70(5):348-355. doi: 10.1097/MAT.0000000000002124. Epub 2024 Jan 3.
This study aimed to assess patients of working age returning to professional employment as a surrogate marker for functional recovery and psychosocial reintegration after ventricular assist device (VAD) implantation. A national, multicenter study considered professional employment and its relationship to sociodemographic, psychosocial, and clinical adverse outcomes in outpatients on VAD support. Patient-reported outcome measures were administered. The survey had a 72.7% response rate. Mean age of 375 subjects was 58 ± 11 years, 53 (14%) were female. Thirty-five patients (15.15%; 95% confidence interval [CI] = 10.9-20.6) were employed, and the majority of them (n = 29, 82.9%) were bridged to transplantation. A regression model after variable selection revealed younger age (odds ratio [OR] = 0.95; 95% CI = 0.91-0.98; p < 0.005), and higher education (OR = 3.05; 95% CI = 1.72-5.41; p < 0.001) associated with professional employment. Employed patients reported higher health-related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire [KCCQ] overall sum-score, OR = 1.04; 95% CI = 0.92-1.07; p < 0.007), the OR for those employed was 2.18 (95% CI = 0.89-5.41; p < 0.08) indicating no significant relation for employment and a history of adverse events. In this sample, professional employment was rather small; the likelihood of adverse events was not significantly different between groups. Those employed perceived better overall HRQoL, which may encourage clinicians to support professional employment for selected patients on VAD support.
本研究旨在评估有工作能力的成年患者在心室辅助装置（VAD）植入后的专业就业情况，以此作为功能恢复和社会心理再融入的替代指标。一项全国性、多中心研究考虑了 VAD 支持门诊患者的专业就业及其与社会人口统计学、社会心理和临床不良结局的关系。采用患者报告的结果测量。调查的回复率为 72.7%。375 名受试者的平均年龄为 58±11 岁，53 名（14%）为女性。35 名患者（15.15%；95%置信区间[CI] = 10.9-20.6）有工作，其中大多数（n = 29，82.9%）是桥接移植。经变量选择的回归模型显示，年龄较小（优势比[OR] = 0.95；95%CI = 0.91-0.98；p < 0.005）和接受过更高教育（OR = 3.05；95%CI = 1.72-5.41；p < 0.001）与专业就业相关。有工作的患者报告了更高的健康相关生活质量（HRQoL）（堪萨斯城心肌病问卷[KCCQ]总评分，OR = 1.04；95%CI = 0.92-1.07；p < 0.007），有工作的患者的 OR 为 2.18（95%CI = 0.89-5.41；p < 0.08），表明就业与不良事件史之间没有显著关系。在本样本中，专业就业的比例相当小；两组之间不良事件的发生几率没有显著差异。有工作的患者感知到更好的整体 HRQoL，这可能鼓励临床医生为选定的 VAD 支持患者提供专业就业支持。
