Patterns and predictors of physical functional disability at 5 to 10 years after heart transplantation.
BACKGROUND
Researchers have not examined relationships between perception of physical functional disability and demographic, clinical, and psychological variables at 5 to 10 years after heart transplantation. Therefore, the purposes of this study were to describe physical functional disability over time and identify predictors of physical functional disability from 5 to 10 years after heart transplantation.


METHODS
The study enrolled 555 patients who were between 5 and 10 years post-heart transplant (age, 54 +/- 9 years; 78% male, 88% white, 79% married). Patients completed 6 instruments that measure physical functional disability and factors that may impact physical functional disability. Statistical analyses included calculation of frequencies, means +/- standard deviation (plotted over time), Pearson correlation coefficients, and multiple regression coupled with repeated measures.


RESULTS
Between 5 and 10 years after heart transplantation, physical functional disability was low, and 34% to 45% of patients reported having no functional disability. More physical functional disability was associated with having more symptoms, having depression/mood/negative affect and lower use of negative coping strategies, having more comorbidities and more specific comorbidities (e.g., more orthopedic problems and diabetes); higher New York Heart Association functional class; having more acute rejection, infection, or cardiac allograft vasculopathy; being female, older, less educated, and unemployed; higher body mass index; and more hospital readmissions (explaining 46% of variance [F = 84.75, p < 0.0001]).


CONCLUSIONS
Demographic, clinical, and psychological factors were significantly related to physical functional disability. Knowledge of these factors provides the basis for development of therapeutic plans of care.
Grady
Kathleen L
KL
Northwestern Memorial Hospital, Chicago, Illinois, USA. kgrady@nmh.org
Naftel
David C
DC
Young
James B
JB
Pelegrin
Dave
D
Czerr
Jennifer
J
Higgins
Robert
R
Heroux
Alain
A
Rybarczyk
Bruce
B
McLeod
Mary
M
Kobashigawa
Jon
J
Chait
Julie
J
White-Williams
Connie
C
Myers
Susan
S
Kirklin
James K
JK
D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D004185:Disability Evaluation; D006233:Persons with Disabilities; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D016027:Heart Transplantation / Q000009:adverse effects / Q000502:physiology* / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009068:Movement / Q000502:physiology; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care / Q000523:psychology; D012737:Sex Factors