Himali Weerahandi1, Nathan Goldstein2, Laura P Gelfman2, Ulrich Jorde3, James N Kirkpatrick4, Judith Marble5, Yoshifumi Naka6, Sean Pinney7, Mark S Slaughter8, Emilia Bagiella9, Deborah D Ascheim10. 1. Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: himali.weerahandi@nyumc.org. 2. Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 3. Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA. 4. Department of Medicine, University of Washington Medicine, Seattle, Washington, USA. 5. Department of Surgery, Heart and Vascular Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 6. Department of Surgery, Columbia University, College of Physicians and Surgeons, New York, New York, USA. 7. Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 8. Thoracic and Cardiovascular Surgery Division, Department of Surgery, Jewish Hospital Louisville, Louisville, Kentucky, USA. 9. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 10. Cedars-Sinai Medical Center, Los Angeles, California, USA.
Abstract
CONTEXT: Ventricular assist devices (VADs) have been shown to improve survival and overall quality of life, but there are limited data on pain control and functional status in this patient population. OBJECTIVES: This study examined changes in pain, functional status, and quality of life over time in VAD patients. METHODS: Patients were enrolled in this prospective cohort study before or as early after VAD implant as possible and then followed for up to 48 weeks. The Brief Pain Inventory was used to assess pain. The Katz Independent Activities of Daily Living questionnaire was used to assess functional status. The Kansas City Cardiomyopathy Questionnaire, a 23-item questionnaire covering five domains (physical function, symptoms, social function, self-efficacy, and quality of life), was used to assess quality of life and health status. RESULTS: Eighty-seven patients were enrolled at four medical centers. The median Brief Pain Inventory severity score was 2.8 (interquartile range 0.5-5.0) before implantation and 0.0 (interquartile range 0.0-5.3) 48 weeks after implantation (P = 0.0009). Katz Independent Activities of Daily Living summary scores also demonstrated significant improvement over time (P < 0.0001). Kansas City Cardiomyopathy Questionnaire summary scales demonstrated significant improvement with time (P < 0.0016). CONCLUSION: This study demonstrated that patients with VADs experienced improved pain, functional status, and quality of life over time. These data may be useful to help patients make decisions when they are considering undergoing VAD implantation.
CONTEXT: Ventricular assist devices (VADs) have been shown to improve survival and overall quality of life, but there are limited data on pain control and functional status in this patient population. OBJECTIVES: This study examined changes in pain, functional status, and quality of life over time in VAD patients. METHODS:Patients were enrolled in this prospective cohort study before or as early after VAD implant as possible and then followed for up to 48 weeks. The Brief Pain Inventory was used to assess pain. The Katz Independent Activities of Daily Living questionnaire was used to assess functional status. The Kansas City Cardiomyopathy Questionnaire, a 23-item questionnaire covering five domains (physical function, symptoms, social function, self-efficacy, and quality of life), was used to assess quality of life and health status. RESULTS: Eighty-seven patients were enrolled at four medical centers. The median Brief Pain Inventory severity score was 2.8 (interquartile range 0.5-5.0) before implantation and 0.0 (interquartile range 0.0-5.3) 48 weeks after implantation (P = 0.0009). Katz Independent Activities of Daily Living summary scores also demonstrated significant improvement over time (P < 0.0001). Kansas City Cardiomyopathy Questionnaire summary scales demonstrated significant improvement with time (P < 0.0016). CONCLUSION: This study demonstrated that patients with VADs experienced improved pain, functional status, and quality of life over time. These data may be useful to help patients make decisions when they are considering undergoing VAD implantation.
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