Pain and Functional Status in Patients With Ventricular Assist Devices

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• 作者：Himali Weerahandi ; MD ; MPH^a ; ^{himali.weerahandi@nyumc.org" class="auth_mail" title="E-mail the corresponding author} ; Nathan Goldstein ; MD^b ; Laura P. Gelfman ; MD^b ; Ulrich Jorde ; MD^f ; James N. Kirkpatrick ; MD^g ; Judith Marble ; RN^h ; Yoshifumi Naka ; MD ; PhDⁱ ; Sean Pinney ; MD^c ; Mark S. Slaughter ; MD^j ; Emilia Bagiella ; PhD^d ; Deborah D. Ascheim ; MD^e
• 关键词：Heart failure ; ventricular assist device ; pain ; functional status ; quality of life
• 刊名：Journal of Pain and Symptom Management
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：52
• 期：4
• 页码：483-490.e1
• 全文大小：451 K

文摘

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.