Ventricular assist devices: A review of psychosocial risk factors and their impact on outcomes

Courtenay Bruce, Estevan Delgado, Kristin Kostick, Sherry Grogan, Ashrith Guha, Barry H. Trachtenberg, Jerry D. Estep, Arvind Bhimaraj, Linda Pham, Jennifer S. Blumenthal-Barby

Research output: Contribution to journalReview articlepeer-review

31 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)996-1003
Number of pages8
JournalJournal of Cardiac Failure
Volume20
Issue number12
DOIs
StatePublished - Dec 1 2014

Keywords

  • LVAD
  • ambulation
  • depression
  • frailty
  • outcomes
  • self-care

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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