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Quality of Life Metrics in LVAD Patients after Hemocompatibility-Related Adverse Events.

BACKGROUND
Hemocompatibility-related adverse events (HRAE) negatively influence survival. However, no study has examined the impact of these events on health-related quality of life (HRQOL) and functional outcomes following continuous flow left ventricular assist device implantation (CF-LVAD). We assessed the impact of HRAE events on HRQOL and hypothesized that HRAE's adversely impact HRQOL and functional outcomes.


METHODS
INTERMACS database identified patients undergoing primary CF-LVAD implantation from 2008 to 2017. HRAEs included stroke, non-surgical bleeding, hemolysis, and pump thrombosis and were identified as defined in the literature. HRAEs were further stratified as Tier 1-2 and disabling stroke events. Time-series analysis was executed for HRAE patients with values pre-HRAE, post-HRAE, and closest to 12 month follow up. Local polynomial regression curves modeling individual patients were superimposed into "spaghetti" plots.


RESULTS
All HRQOL and functional metrics improved in patients over time, despite HRAE complication. However, these patient metrics were significantly reduced compared to the non-HRAE cohort (Table 2). Advanced data visualization techniques noted decline after experiencing an HRAE with a subsequent recovery to baseline levels or higher (Figure1-4). 6MWT was noted to be most affected in the post-HRAE period but recovered similar to other metrics (Table 3).


CONCLUSIONS
The burden of HRAE following CF-LVAD implantation did not negatively impact quality of life. However, 6-minute walk test did not increase in the post-HRAE period in all HRAE patients. Improvement of heart failure symptoms after CF-LVAD coupled with optimal management following HRAE act to preserve enhanced quality of life.