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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Spaderna, H; Weidner, G; Koch, KC; Kaczmarek, I; Wagner, FM; Smits, JM, , Waiting, for, a, New, Heart, Study, Group, , Waiting, for, a, New, Heart, Study, Group.
Medical and psychosocial predictors of mechanical circulatory support device implantation and competing outcomes in the Waiting for a New Heart Study.
J Heart Lung Transplant. 2012; 31(1): 16-26. Doi: 10.1016/j.healun.2011.07.018
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Study Group Mitglieder der Med Uni Graz:
Kahn Judith
Tscheliessnigg Karlheinz

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BACKGROUND: Medical and psychosocial factors are related to 1-year outcomes in the Waiting for a New Heart Study. With increased use of mechanical circulatory support devices (MCSD) over the course of the study, we can now evaluate these variables as predictors of MCSD in an extended follow-up. METHODS: Analyses focused on 313 MCSD-free patients (82% men; aged 53 ± 11 years) newly listed for heart transplantation (HTx). Variables assessed at time of listing included psychosocial risk (depression, social isolation), quality of life, waiting list stress, and medical risk (Heart Failure Survival Score, pulmonary capillary wedge pressure). Cumulative incidence functions and cause-specific Cox models examined the association of medical and psychosocial risk (low: non-depressed and socially integrated; medium: depressed or socially isolated; high: depressed and socially isolated) with time until MCSD, considering covariates and competing outcomes (death, high-urgency transplantation [HU-HTx], elective HTx, and delisting due to clinical improvement or deterioration). RESULTS: Psychosocial risk groups were comparable regarding demographics, medical parameters, and quality of life, but differed in waiting list-related stressors. During follow-up (median, 326; range, 5-1,849 days), 26 patients received MCSD, 53 died, 144 underwent HTx (103 in HU status), and 53 were delisted (15 deteriorated, 31 improved). Non-depressed and socially integrated patients did not require MCSD. Controlling for medical risk, psychosocial risk significantly contributed to MCSD, HU-HTx, and improvement; medical risk and female gender predicted death (p < 0.05). CONCLUSIONS: Psychosocial risk at time of listing affects the prognosis of HTx candidates beyond medical risk. Psychosocial interventions may help to stabilize patients' health.
Find related publications in this database (using NLM MeSH Indexing)
Depression - epidemiology, psychology
Female - administration & dosage
Follow-Up Studies - administration & dosage
Heart Failure - psychology, surgery
Heart Transplantation - psychology
Heart-Assist Devices - administration & dosage
Humans - administration & dosage
Incidence - administration & dosage
Male - administration & dosage
Middle Aged - administration & dosage
Netherlands - epidemiology
Outcome Assessment, Health Care - administration & dosage
Prognosis - administration & dosage
Prospective Studies - administration & dosage
Psychometrics - methods
Risk Assessment - administration & dosage
Severity of Illness Index - administration & dosage
Treatment Outcome - administration & dosage
Waiting Lists - administration & dosage

Find related publications in this database (Keywords)
heart failure
mechanical circulatory support
Heart Failure Survival Score
psychosocial risk
waiting list
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