Self-reported quality of life in children with ventricular assist devices.

Abstract

We sought to describe QOL in children with VAD and to identify factors associated with impaired QOL. There were 82 children (6-19years) in the Pediatric Interagency Registry for Mechanical Circulatory Support who completed the PedsQL +/- a VAD-specific QOL assessment pre-VAD implant (n=18), 3months post-VAD (n=63), and/or 6months post-VAD (n=38). Significantly impaired QOL is a score >1 SD below norms. Study patients were 59% male, 67% Caucasian, with cardiomyopathy diagnosis in 82%, and median age at implant of 14 y (IQR 11-17). PedsQL scores were lower than norms for physical (p<.0001) and psychosocial (p<.01) QOL in pre- and post-VAD groups. Compared to chronic health condition and complex or severe heart disease groups, PedsQL scores were lower for physical and psychosocial QOL in the pre-VAD group (p<.0001); however, psychosocial QOL was not significantly different in post-VAD groups. Psychosocial QOL was impaired in 67%, 40%, and 24% in pre-VAD, 3-month, and 6-month post-VAD groups, respectively. Total and psychosocial QOL scores were significantly higher in the 3-month and 6-month post-VAD group than pre-VAD (all p≤.02). VAD patients were most bothered by their inability to participate in usual play activities. Impaired QOL 3months post-VAD was associated with inotropic support >2weeks/ongoing post-VAD (p=.04). Physical QOL is significantly impaired in most children pre- and post-VAD. However, psychosocial QOL is not significantly impaired in most children post-VAD suggesting VAD implantation may improve psychosocial QOL in children.