Quality of life outcomes in left ventricular assist system inpatients and outpatients

This study empirically evaluates the quality of life (QOL) effects associat ed with hospital discharge among heart transplant candidates whose lives ar e maintained by left ventricular support systems (LVAS). Thirty-five LVAS i npatients (18 Novacor, 17 Thoratec) received structured QOL assessments app roximately 1 month after device implant. Ten of the patients (8 Novacor, 2 Thoratec) were subsequently discharged to either home or a home-like outpat ient facility where their QOL was reassessed. The QOL of LVAS patients, bef ore and after discharge, was compared with that of demographically similar nonhospitalized heart transplant candidates (n = 55) and recipients (n = 97 ). Their caregivers' QOL was also assessed. The QOL of LVAS outpatients sho wed statistically significant (p < 0.05) advantages over remaining LVAS inp atients and nonhospitalized heart candidates. Advantages appeared in physic al, emotional, and social functioning domains. The QOL of LVAS outpatients also improved (p < 0.05) over their own QOL before discharge, with the grea test change in physical functional and emotional status. The QOL of LVAS ou tpatients most closely resembled QOL in the transplant recipients. Family c aregivers to LVAS outpatients reported some increases in caregiving burden after patient discharge, but their overall well being was not adversely aff ected. These data provide an empiric basis for the provision of outpatient programs as appropriate care for eligible LVAS patients.