10.11589/VAD/E20228112
Chesher, Nicholas J.
Nicholas J.
Chesher
Greenwood, Kristina L.
Kristina L.
Greenwood
Fanale, Candace
Candace
Fanale
Gustavenson, Cody
Cody
Gustavenson
Jaski, Brian
Brian
Jaski
Mehta, Hirsch S.
Hirsch S.
Mehta
Hoagland, Peter
Peter
Hoagland
Ortiz, Kristine
Kristine
Ortiz
Verlasky, Marc
Marc
Verlasky
Adamson, Robert
Robert
Adamson
Dembitsky, Walter
Walter
Dembitsky
Predicting Left Ventricular Assist Device Outcomes Utilizing the Stanford Integrated Psychosocial Assessment for Transplant Measure
The VAD Journal
2022
Manuscript
FOS: Medical and health sciences
FOS: Clinical medicine
2022-06-27
2022-11-10
2022-11-20
en
9 pages
PDF
Creative Commons Attribution 4.0 International
Objective: Durable mechanical circulatory support is a proven therapy to extend
survival for patients with end-stage heart failure (HF). The International Society for
Heart and Lung Transplantation guidelines recommend a detailed psychosocial
assessment when selecting candidates for durable mechanical circulatory support.
Currently, there are no formally validated psychosocial evaluation tools for left
ventricular assist device (LVAD) candidacy. The Stanford Integrated Psychosocial
Assessment for Transplantation (SIPAT) uses a multidisciplinary algorithm to
evaluate the impact of pre-transplant risk factors on post-transplant outcomes.
Emerging literature suggests that the SIPAT might be useful for assessing
psychosocial risk factors for LVAD outcomes.
Methods: A total of 268 consecutive patients (median age 66 years, 84.6% male)
with terminal HF were evaluated before LVAD implantation with a SIPAT
assessment. Key outcomes included readmission and mortality rates at 30 days and
two years.
Results: After screening, 234 subjects met the inclusion criteria and were analyzed.
The Patient Readiness subscale of the SIPAT was statistically significant in
predicting two-year mortality (B = .167, P < .001; Nagelkerke r2 = .106). Scores on
the SIPAT did not correlate to 30-day readmission, 30-day mortality, or two-year
readmission rates.
Discussion: In this study, only the Patient Readiness score was associated with
mortality at two-years post-implantation. This research elucidates the potential
longer-term impact of psychosocial factors on LVAD outcomes and the SIPAT’s
utility in evaluating LVAD candidacy.
Chesher. Predicting Left Ventricular Assist Device Outcomes Utilizing the Stanford Integrated Psychosocial Assessment for Transplant Measure. The VAD Journal. 2022; 8(1):e20228112. https://doi.org/10.11589/vad/e
20228112.