Post-Discharge Functional Capacity, Health-Related Quality of Life, Depression, Anxiety and Post-traumatic Stress Disorder in Patients Receiving a Long-term Left Ventricular Assist Device

Abstract Background : There is a paucity of data on depression, anxiety and post-traumatic stress disorder (PTSD) after left ventricular assist device (LVAD) implantation. We designed an observational study to integrate these with functional capacity and health-related quality of life (HR-QOL) in surviving LVAD patients. Methods : Consenting patients between one month and 9 years post-LVAD implantation (n = 121) were screened for functional capacity (WHO Disability Assessment Schedule 2.0 [WHODAS 2.0)]); HR-QOL (European Quality of Life [EQ-5D] and Visual Assessment Scales [EQ-VAS]), depression (Patient Health Questionnaire [PHQ-9], anxiety (Generalized Anxiety Disorder Scale [GAD-7]) and PTSD (Impact of Event Scale Revised [IES-R]). Results : Of the 94% of patients who consented, 34.7% reported impaired functional capacity (WHODAS 2.0 score ≥ 25%), 23.1-34.7% HR-QOL problems (domain EQ-5D ≥ 3), 10.7% “poor health” (EQ-VAS ≤ 40), 14.9% depression (PHQ-9 > 14), 11.7% suicidal ideation and 17.5% anxiety (GAD-7 >10). 23.5% had a positive screen for PTSD (IES-R ≥ 24). EQ-VAS ≥ 80 predicted good functional capacity (p Conclusions : A third of discharged LVAD patients reported impaired function, HR-QOL and psychological issues. Standardized evaluation before and after LVAD implantation could facilitate psychologic prehabilitation, inform decision-making and identify indications for mental health intervention.