Change in Quality of Life from Before to After Discharge Following Left Ventricular Assist Device Implantation

Kathleen L. Grady, St. Luke's Medical Center - Chicago, IL
Peter M. Meyer, University of Pennsylvania
Annette Mattea, University of Pennsylvania
Diane K. Dressler, Marquette University
Sophia Ormaza, University of Minnesota - Twin Cities
Connie White-Williams, University of Alabama - Birmingham
Suzanne Chillcott, University of Pennsylvania
Annemarie Kaan, University of Pennsylvania
Alice Loo, University of Pennsylvania
Barbara Todd, University of Pennsylvania
Annette Klemme, University of Pennsylvania
William Piccione, St. Luke's Medical Center - Chicago, IL
Maria Rosa Constanzo, St. Luke's Medical Center - Chicago, IL

The Journal of Heart and Lung Transplantation, Vol. 22, No. 3 (March 2003): 322-333. DOI: 10.1016/S1053-2498(02)00668-X.


Background: Quality of life (QOL) outcomes after left ventricular assist device (LVAD) implantation from before to after hospital discharge have been examined only in a very small sample of patients. The purposes of this study are to describe change in QOL from before to after hospital discharge in LVAD patients and to determine whether being discharged with an LVAD predicts better QOL than being hospitalized with an LVAD.

Methods: A non-random sample of 62 LVAD patients (approximately 50 years old, male, white, married, fairly well-educated) completed self-report questionnaires at ≥2 timepoints post-implant. The questionnaires (Quality of Life Index, Rating Question Form, Heart Failure Symptom Checklist, Sickness Impact Profile, LVAD Stressor Scale, Jalowiec Coping Scale), which were collated into booklets, had acceptable reliability and validity. Longitudinal analyses were performed in 2 steps using 1-sample t-tests and linear mixed effects modeling.

Results: Perception of QOL and health status were fairly good both before and after discharge of LVAD patients. Discharge predicted increased satisfaction with socioeconomic areas of life; decreased overall and psychologic stress and stress related to family and friends, self-care and work/school/finances; and decreased physical and self-care disability.

Conclusions: QOL outcomes improved from before to after hospital discharge in LVAD patients awaiting heart transplantation. As LVADs potentially become available as destination therapy, in addition to being successful bridges to heart transplantation, QOL outcomes will become more important to study.