Differences in Health-Related Quality of Life by Socio-Demographic Characteristics: Findings from the Sustaining Quality of Life of the Aged: Transplant or Mechanical Support (SUSTAIN-IT) Study

Abstract

Purpose Sociodemographic comparisons in outcomes of patients (pts) with heart failure (HF) typically focus on morbidity and mortality, not health-related quality of life (HRQOL). We examined differences in HRQOL by race (white vs non-white), gender, and insurance type (private vs Medicare/Medicaid) in advanced HF pts prior to heart transplantation (HT) or mechanical circulatory support as destination therapy (DT MCS). Methods We enrolled 344 pts awaiting HT (n=207, 100 with MCS and 107 without MCS) and DT MCS (n=137) at 13 U.S. sites from 10/1/15-9/15/18. HRQOL was measured using the generic EQ-5D-3L (Visual Analog Scale [VAS]: 0-100=worst to best health state) and HF-specific KCCQ-12 (0-100=lowest to highest health status). Statistical analyses included descriptive summaries, t-tests and baseline-adjusted regression models. Results Most pts were white and male. The DT MCS group was older than the HT group (DT = 68.6±5.1 vs HT with MCS = 64.5±3.3 vs HT without MCS = 64.0±2.9 years, p Conclusion Socio-demographic differences in overall HRQOL were found only for pts prior to DT MCS, but not HT. Furthermore, DT pts also had worse pre-operative overall HRQOL than HT pts with MCS. These race- and gender-specific differences in overall HRQOL require further research and may assist clinicians to target HRQOL-focused therapies to DT MCS pts.