TY - JOUR
T1 - Ventricular assist devices
T2 - A review of psychosocial risk factors and their impact on outcomes
AU - Bruce, Courtenay
AU - Delgado, Estevan
AU - Kostick, Kristin
AU - Grogan, Sherry
AU - Guha, Ashrith
AU - Trachtenberg, Barry H.
AU - Estep, Jerry D.
AU - Bhimaraj, Arvind
AU - Pham, Linda
AU - Blumenthal-Barby, Jennifer S.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Background Psychosocial contraindications for ventricular assist devices (VADs) remain particularly nebulous and are driven by institution-specific practices. Our multi-institutional, multidisciplinary workgroup conducted a review with the goal of addressing the following research question: How are preoperative psychosocial domains predictive of or associated with postoperative VAD-related outcomes? Answers to this question could contribute to the development of treatment-specific (contra) indications for patients under consideration for mechanical devices.Methods and Results We identified 5 studies that examined psychosocial factors and their relationship to postoperative VAD-related outcomes. Our results suggest that 3 psychosocial variables are possibly associated with VAD-related outcomes: depression, functional status, and self-care. Of the few studies that exist, the generalizability of findings is constrained by a lack of methodologic rigor, inconsistent terminology, and a lack of conceptual clarity.Conclusions This review should serve as a call for research. Efforts to minimize psychosocial risk before device placement can only be successful insofar as VAD programs can clearly identify who is at risk for suboptimal outcomes.
AB - Background Psychosocial contraindications for ventricular assist devices (VADs) remain particularly nebulous and are driven by institution-specific practices. Our multi-institutional, multidisciplinary workgroup conducted a review with the goal of addressing the following research question: How are preoperative psychosocial domains predictive of or associated with postoperative VAD-related outcomes? Answers to this question could contribute to the development of treatment-specific (contra) indications for patients under consideration for mechanical devices.Methods and Results We identified 5 studies that examined psychosocial factors and their relationship to postoperative VAD-related outcomes. Our results suggest that 3 psychosocial variables are possibly associated with VAD-related outcomes: depression, functional status, and self-care. Of the few studies that exist, the generalizability of findings is constrained by a lack of methodologic rigor, inconsistent terminology, and a lack of conceptual clarity.Conclusions This review should serve as a call for research. Efforts to minimize psychosocial risk before device placement can only be successful insofar as VAD programs can clearly identify who is at risk for suboptimal outcomes.
KW - LVAD
KW - ambulation
KW - depression
KW - frailty
KW - outcomes
KW - self-care
UR - http://www.scopus.com/inward/record.url?scp=84920042282&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84920042282&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2014.09.006
DO - 10.1016/j.cardfail.2014.09.006
M3 - Review article
C2 - 25239054
AN - SCOPUS:84920042282
SN - 1071-9164
VL - 20
SP - 996
EP - 1003
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 12
ER -