Abstract
s S25 Purpose: Longitudinal change in health-related quality of life (HRQOL) by left ventricular assist device (LVAD) implant strategy is unknown. The purpose of this study was to examine if generic and heart failure-specific HRQOL differs by pre-operative implant strategy from pre-implant to 2 years (yrs) post implant. Methods: Data from adult patients (pts) in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) were stratified into three groups: destination therapy (DT), bridge to transplant (BTT), and bridge to candidacy (BTC [BTT likely, moderately likely, and unlikely]). Data were collected pre-implant and 1yr and 2yrs post implant. HRQOL was measured with the EQ-5D-3L generic survey visual analog scale [VAS health status, 0= worst-100= best), and heart failure (HF)-specific KCCQ12 overall summary (OS) score of 4 domains (physical limitations, symptom frequency, quality of life, and social limitations). Statistical analyses included descriptive statistics, chi square, analysis of variance, and paired t-tests. Results: Between 04/01/08-06/30/13, 7227 and 4505 pts who received primary continuous flow LVADs had VAS and KCCQ-12 HRQOL data, respectively, at baseline. Longitudinally, mean VAS scores for all 3 groups improved significantly from pre to 2 yrs post implant (figure 1). Similar to the VAS, KCCQ-12 OS scores improved over time for all 3 groups (figure 1). Sensitivity analyses, using only paired data (pre implant and 2 years post implant), for both the EQ-5D-3L VAS and KCCQ-12 OS support these findings. Conclusion: Overall, HRQOL improves from before to 2 yrs after LVAD implant for pts with all 3 implant strategies, assessed by both a generic and HF-specific instrument. These findings suggest that all implant strategy groups, regardless of intent to transplant or not, may derive HRQOL-related benefit from before to mid-term after LVAD implantation.
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