Impact of Socioeconomic Factors on Patient Desire for Early LVAD Therapy Prior to Inotrope Dependence
| Autor: | Douglas L. Mann, Anuradha Lala, Revival Investigators, Garrick C. Stewart, Shokoufeh Khalatbari, Ulrich P. Jorde, Keyur B. Shah, Matheos Yosef, J. Timothy Baldwin, Jerry D. Estep, Inna Tchoukina, Rhondalyn C. McLean, Donald C. Haas, Nisha A. Gilotra, Cathie Spino, Dennis M. McNamara, Salpy V. Pamboukian, Douglas A. Horstmanshof, David E. Lanfear, Jennifer T. Thibodeau, Blair Richards, Thomas Cascino, Keith D. Aaronson |
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| Rok vydání: | 2020 |
| Předmět: |
Inotrope
medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine Quality of life medicine Humans Prospective Studies 030212 general & internal medicine Socioeconomic status Heart Failure business.industry Odds ratio equipment and supplies medicine.disease Confidence interval Treatment Outcome Socioeconomic Factors Ventricular assist device Heart failure Emergency medicine Ambulatory Quality of Life Heart-Assist Devices Cardiology and Cardiovascular Medicine business |
| Zdroj: | J Card Fail |
| ISSN: | 1071-9164 |
| Popis: | Background Worsening heart failure (HF) and health-related quality of life (HRQOL) have been shown to impact the decision to proceed with left ventricular assist device (LVAD) implantation, but little is known about how socioeconomic factors influence expressed patient preference for LVAD. Methods and Results Ambulatory patients with advanced systolic HF (n=353) reviewed written information about LVAD therapy and completed a brief survey to indicate whether they would want an LVAD to treat their current level of HF. Ordinal logistic regression analyses identified clinical and demographic predictors of LVAD preference. Higher New York Heart Association (NYHA) class, worse HRQOL measured by Kansas City Cardiomyopathy Questionnaire, lower education level, and lower income were significant univariable predictors of patients wanting an LVAD. In the multivariable model, higher NYHA class (OR [odds ratio]: 1.43, CI [confidence interval]: 1.08–1.90, P = .013) and lower income level (OR: 2.10, CI: 1.18 – 3.76, P = .012 for $80,000) remained significantly associated with wanting an LVAD. Conclusion Among ambulatory patients with advanced systolic HF, treatment preference for LVAD was influenced by level of income independent of HF severity. Understanding the impact of socioeconomic factors on willingness to consider LVAD therapy may help tailor counseling towards individual needs. |
| Databáze: | OpenAIRE |
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