(589) - Psychosocial Assessment of Candidates for Transplantation Score and Readmissions in HeartMate II Bridge to Transplant Left Ventricular Assist Device Patients

Abstract

The psychosocial assessment of candidates for transplantation (PACT) score is well validated in transplant populations but is not well studied in bridge to transplant (BTT) LVAD (left ventricular assist device) recipients. We sought to characterize PACT score impact in BTT patients receiving a HeartMate II (HM2) device. All BTT patients that underwent HM2 LVAD implant from January 2008 to July 2013 were retrospectively analyzed. PACT scores were completed in 51 of the 71 total patients prior to LVAD implant. Transplantation was considered an endpoint. Patients that died during initial LVAD hospitalization were excluded. We reviewed readmissions after initial LVAD hospitalization in the 48 remaining patients with PACT scores. We identified 48 patients with PACT scores ranging from 1 to 4. Due to small sample size and potential skewing of outliers, we used mode to determine readmissions for each PACT score. A mode of 2, 1, 0, and 0 readmissions was associated with a PACT of 1, 2-2.5, 3, and 4, respectively (Figure 1). 0% of patients with a PACT of 1, 43% with a PACT of 2-2.5, 63% with a PACT of 3, and 67% with a PACT of 4 were transplanted (Figure 2). Statistical significance was not achieved due to small sample size. Higher PACT scores correlated with fewer readmissions and greater percentage of patients undergoing heart transplantation in HM2 BTT LVAD patients. No such score exists for destination therapy (DT) LVAD patients. Implementing PACT scores for DT LVAD recipients may hold potential to aid in predicting readmissions.FigView Large Image Figure ViewerDownload Hi-res image Download (PPT)