Younger LVAD Recipients Fare Worse on Emotional and Spiritual Wellbeing Scores
Mudigonda P, Sandau KE, Hoffman RO, Jaganathan SP, Eckman P, Garberich R, Weaver CE, Joseph S, Hall S, Carey S, Cowger J, Chaudhry SP, Schroeder SE, Conway G, Birati EY, Soni M, Marble J, Lee CS, Faulkner KM, Kunz MS, Storey KM, and Feldman DS. Younger LVAD Recipients Fare Worse on Emotional and Spiritual Wellbeing Scores. J Heart Lung Transplant 2019; 38(4 Suppl ):S440-S441.
J Heart Lung Transplant
Purpose: With growing use of Left ventricular assist devices (LVAD) and a limited donor supply, it is imperative to understand the impact LVADs may have on a young and potentially working population, where psychological morbidity predicts poor health related to compliance, self-care, hospitalizations and worse outcomes.
Methods: The Quality of Life with a Left Ventricular Assist Device (QOLVAD) questionnaire is a valid and reliable measure of overall QOL and includes 5 domain specific scores, including Emotional and Meaning/Spiritual Domains. As part of a prospective, cross-sectional multi-site study evaluating QOL, we examined age for a significant difference in the emotional and spiritual domains. We also compared age with depressive symptoms (PHQ9). anxiety (PROMIS), and spiritual wellbeing (FACIT-Sp). Two-sample T-tests were conducted using STATA®.
Results: The QOLVAD tool was used on a sample of 186 patients from 7 centers across the United States, including 68 (37%) with age ≤ 55 years. The mean age was 58.5±13.8; 82.7% were male, 77.3% were White and 21.5% Black, 50% were a bridge to transplant, 30.1% destination therapy, and most common LVAD types included HeartMate II (69.1%) and HeartMate 3 (20.6%). Scores for emotional and spiritual wellbeing stratified by age are reported in the table below.
Conclusion: LVAD patients ≤ 55 years had lower Emotional and Meaning/Spiritual Domain QOLVAD scores compared to patients >55 years. Results also suggest that faith may be a strong resource in older patients. Further research may help delineate whether low emotional wellbeing in younger patients is influenced to a greater degree by anxiety than depression. The QOLVAD tool may help clinicians identify patients at risk of poor emotional and spiritual wellbeing earlier and assist in offering support before it compromises functioning. Limitations to this study include a population that is predominantly White and male and a lower number of responses associated with the PROMIS.