Psychosocial Evaluation in Patients Undergoing Left Ventricular Assist Device Implantation Using the Transplant Evaluation Rating Scale.
BACKGROUND
It has been recommended that all candidates for left ventricular assist device (LVAD) implantation undergo preoperative psychologic evaluation for risk assessment.


OBJECTIVE
We used the transplant evaluation rating scale (TERS) that was established for pretransplant evaluation to investigate the psychosocial assessment of patients undergoing LVAD implantation.


METHODS
This study retrospectively analyzed data from 125 patients with advanced heart failure who were evaluated by the TERS before LVAD implantation. Postoperative follow-up included survival, total length of hospital stay, readmissions, and post-LVAD out-of-hospital days after discharge. The cohort was stratified according to the TERS scores into low-, moderate-, and high-risk groups. The outcomes were analyzed to evaluate whether the TERS score was associated with post-LVAD adverse events.


RESULTS
The TERS, when stratified into 3 risk groups showed significant difference in 8 of the 10 psychosocial domains (p < 0.001). The mean number of outpatient days after discharge was significantly different between the low-, moderate-, and high-risk groups (p < 0.001). All other outcomes were not significantly different.


CONCLUSIONS
This study showed that the TERS is successful in stratifying our patients with an LVAD into 3 risk groups, indicating the internal validity of this test. The number of out-of-hospital (outpatient) days after discharge was significantly shorter in the TERS high-risk group, which may affect the quality of life and cost of post-LVAD care.
Advocate Christ Medical Center, Center for Heart Transplant and Assist Devices, Oak Lawn, IL (GLY, GB, KNI, AGK, EM).
Gardner L
GL
Yost
Advocate Christ Medical Center, Center for Heart Transplant and Assist Devices, Oak Lawn, IL (GLY, GB, KNI, AGK, EM). Electronic address: geetha.bhat@advocatehealth.com.
Geetha
G
Bhat
Advocate Christ Medical Center, Center for Heart Transplant and Assist Devices, Oak Lawn, IL (GLY, GB, KNI, AGK, EM).
Kamel N
KN
Ibrahim
Advocate Christ Medical Center, Center for Heart Transplant and Assist Devices, Oak Lawn, IL (GLY, GB, KNI, AGK, EM).
Angela G
AG
Karountzos
Division of Cardiology, Advocate Masonic Medical Center, Chicago, IL (MC).
Mercy
M
Chandrasekaran
Advocate Christ Medical Center, Center for Heart Transplant and Assist Devices, Oak Lawn, IL (GLY, GB, KNI, AGK, EM).
Edward
E
Mahoney
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005195:Family Relations; D005260:Female; D015438:Health Behavior; D006333:Heart Failure / Q000523:psychology* / Q000628:therapy; D006353:Heart-Assist Devices; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D010349:Patient Compliance; D010359:Patient Readmission; D011300:Preoperative Care; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012944:Social Support; D019966:Substance-Related Disorders / Q000453:epidemiology