title: Predictors of changes in health status between and within patients 12 months post left ventricular assist device implantation.
abstract: BACKGROUND
  Improving patient-reported outcomes (e.g. health status) has become an important goal in left ventricular assist device (LVAD) therapy, in addition to reducing mortality and morbidity. We examined predictors of changes in health status scores between and within patients 12 months post LVAD implantation.
  
  
  METHODS
  Health status [Kansas City Cardiomyopathy Questionnaire (KCCQ); Short-Form 12 (SF-12)] were assessed at 3-4 weeks after implantation, and at 3, 6 and 12 months follow up in 54 LVAD patients (74% men; mean age 54 ± 9 years).
  
  
  RESULTS
  Patients experienced significant improvements in health status between baseline and 3 months follow-up as assessed by the KCCQ (clinical summary score: F = 33.49, P < 0.001; overall summary score: F = 31.13, P < 0.001) and the SF-12 (physical component score: F = 31.59, P < 0.001; mental component score: F = 21.77, P < 0.001), but not between 3 months and 12 months follow-up (P > 0.05 for all). Higher scores on anxiety and depression over time, older age, lower ejection fraction, and more co-morbidity were associated with poorer health status scores on one or both of the KCCQ and SF-12 subscales. The majority of the between-patient variance of the mental component summary scores (82.6%), but not the KCCQ overall summary score (41.9%), KCCQ clinical summary score (36.2%) and physical component summary scores (23.2%), was explained by the sociodemographic, clinical and psychological factors.
  
  
  CONCLUSIONS
  The majority of LVAD patients show a significant improvement in health status after LVAD implantation. However, there are large differences in individual health status score trajectories which are only partly explained by measures of disease severity pre-LVAD, co-morbidity and psychological stress.
authors.affiliation: CoRPS - Centre of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
authors.forename: Corline
authors.initials: C
authors.lastname: Brouwers
authors.forename: Nicolaas
authors.initials: N
authors.lastname: de Jonge
authors.forename: Kadir
authors.initials: K
authors.lastname: Caliskan
authors.forename: Olivier
authors.initials: O
authors.lastname: Manintveld
authors.forename: Quincy-Robyn
authors.initials: QR
authors.lastname: Young
authors.forename: Annemarie
authors.initials: A
authors.lastname: Kaan
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kealy
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
mesh_terms: D000223:Adaptation, Psychological; D000367:Age Factors; D001243:Assisted Circulation / Q000295:instrumentation / Q000379:methods / Q000523:psychology; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D054624:Health Status Disparities; D006333:Heart Failure / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011788:Quality of Life; D012307:Risk Factors; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: (end-stage) Heart failure; Health status; LVAD