TY - JOUR
T1 - Two-year follow-up of quality of life in patients referred for heart transplant
AU - Evangelista, Lorraine S.
AU - Dracup, Kathleen
AU - Moser, Debra K.
AU - Westlake, Cheryl
AU - Erickson, Virginia
AU - Hamilton, Michele A.
AU - Fonarow, Gregg C.
N1 - Funding Information:
This research was partially supported by a grant from the American Heart Association Western Division (NCR, 133–09, PI, K. Dracup) and from the University of California School of Nursing Intramural Research Grant.
PY - 2005/5
Y1 - 2005/5
N2 - BACKGROUND: Assessment of physical and mental health has become one of the ultimate tests of health-related quality of life (HRQOL) for patients with advanced heart failure. Little is known, however, about the comparative effects of surgical or medical treatment on the HRQOL of these chronically ill patients over time. METHODS: We examined 77 patients (74% of whom were male), aged 56.1 ± 12.7 years who were referred for heart transplant evaluation at a single heart failure center to describe the effects of time and treatment status on changes in HRQOL scores (physical and mental health and depression) using the Short Form-12 and the Beck Depression Inventory at 2 time points during their illness trajectory. The 2 evaluations on average were 2 years apart (mean 24.5 ± 2.8 months). All patients were evaluated at baseline, and 3 groups were identified at the time of the 2-year follow-up: transplant recipients (n = 17), transplant candidates (n = 13), and medically stable patients considered too well to receive a transplant (n = 47). Nonparametric statistics were used to analyze group differences in HRQOL scores. The significance level was set at a P value less than. 05. RESULTS: Demographic and HRQOL scores were not significantly different among the 3 groups at baseline. During follow-up, physical health and depression scores significantly improved over time in all patients, but changes in mental health were minimal. Group comparisons showed that although all patients continued to have low HRQOL scores at the time of follow-up evaluation, medically stable patients had higher mental health scores and less depressive symptoms than their counterparts. CONCLUSION: Our results support the need for ongoing HRQOL assessment with an emphasis on timely recognition and treatment of psychologic distress throughout the heart failure illness trajectory. Heart transplant recipients and candidates equally need special attention and follow-up because they both seem to have emotional and psychologic repercussions.
AB - BACKGROUND: Assessment of physical and mental health has become one of the ultimate tests of health-related quality of life (HRQOL) for patients with advanced heart failure. Little is known, however, about the comparative effects of surgical or medical treatment on the HRQOL of these chronically ill patients over time. METHODS: We examined 77 patients (74% of whom were male), aged 56.1 ± 12.7 years who were referred for heart transplant evaluation at a single heart failure center to describe the effects of time and treatment status on changes in HRQOL scores (physical and mental health and depression) using the Short Form-12 and the Beck Depression Inventory at 2 time points during their illness trajectory. The 2 evaluations on average were 2 years apart (mean 24.5 ± 2.8 months). All patients were evaluated at baseline, and 3 groups were identified at the time of the 2-year follow-up: transplant recipients (n = 17), transplant candidates (n = 13), and medically stable patients considered too well to receive a transplant (n = 47). Nonparametric statistics were used to analyze group differences in HRQOL scores. The significance level was set at a P value less than. 05. RESULTS: Demographic and HRQOL scores were not significantly different among the 3 groups at baseline. During follow-up, physical health and depression scores significantly improved over time in all patients, but changes in mental health were minimal. Group comparisons showed that although all patients continued to have low HRQOL scores at the time of follow-up evaluation, medically stable patients had higher mental health scores and less depressive symptoms than their counterparts. CONCLUSION: Our results support the need for ongoing HRQOL assessment with an emphasis on timely recognition and treatment of psychologic distress throughout the heart failure illness trajectory. Heart transplant recipients and candidates equally need special attention and follow-up because they both seem to have emotional and psychologic repercussions.
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U2 - 10.1016/j.hrtlng.2004.10.004
DO - 10.1016/j.hrtlng.2004.10.004
M3 - Article
C2 - 16015223
AN - SCOPUS:18944391631
SN - 0147-9563
VL - 34
SP - 187
EP - 193
JO - Heart and Lung: Journal of Acute and Critical Care
JF - Heart and Lung: Journal of Acute and Critical Care
IS - 3
ER -