PMID- 37380090
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231025
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 42
IP  - 11
DP  - 2023 Nov
TI  - Adverse events after left ventricular assist device implantation linked to 
      psychosocial risk in women and men.
PG  - 1557-1568
LID - S1053-2498(23)01920-4 [pii]
LID - 10.1016/j.healun.2023.06.013 [doi]
AB  - BACKGROUND: Reasons for women's increased probability to experience adverse 
      events (AEs) after left ventricular assist device (LVAD) implantation compared 
      with men's remain uncertain. We explored the role of psychosocial risk in the 
      experience of AEs in women and men. METHODS: INTERMACS patients receiving a 
      primary continuous-flow LVAD between July 2006 and December 2017, median 
      follow-up 13.6 months, were included (n = 20,123, 21.3% women). Time-to-event was 
      calculated with cumulative incidence functions for 10 types of AEs separately 
      (e.g., infection, device malfunction), each time accounting for the competing 
      outcomes death, heart transplant, and device explant due to recovery. 
      Event-specific Cox proportional hazard models were run with a binary psychosocial 
      risk variable (including substance abuse, psychiatric diagnosis, limited social 
      support, limited cognition, repeated noncompliance), controlled for covariates. 
      RESULTS: Psychosocial risk was more prevalent in men than in women (21.4% vs 
      17.5%, p < 0.001). Seven out of 10 AEs were more likely in women than in men 
      (e.g., infection 44.5% vs 39.2%, p < 0.001). The association of psychosocial risk 
      with each AE was either stronger in women than in men (e.g., device malfunction 
      HR(adj) 1.29, 95% confidence interval (CI) (1.06-1.56) vs HR(adj) 1.10, 95% CI 
      (0.97-1.25); rehospitalization HR(adj) 1.15, 95% CI (1.02-1.29) vs HR(adj) 1.03, 
      95% CI (0.97-1.10) or similar between sexes. CONCLUSIONS: Independent of clinical 
      parameters, the presence of psychosocial risk is associated with increases in 
      AEs. This suggests that early modification of psychosocial risk factors may have 
      the potential to lower the risk for AEs in this patient population.
CI  - Copyright (c) 2023 International Society for the Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Maukel, Lisa-Marie
AU  - Maukel LM
AD  - Nursing Science, Section Health Psychology, Trier University, Trier, Germany.
FAU - Weidner, Gerdi
AU  - Weidner G
AD  - Biology, San Francisco State University, San Francisco, California.
FAU - Beyersmann, Jan
AU  - Beyersmann J
AD  - Institute of Statistics, Ulm University, Ulm, Germany.
FAU - Spaderna, Heike
AU  - Spaderna H
AD  - Nursing Science, Section Health Psychology, Trier University, Trier, Germany. 
      Electronic address: spaderna@uni-trier.de.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230626
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
SB  - IM
MH  - Male
MH  - Humans
MH  - Female
MH  - *Heart Failure
MH  - *Heart-Assist Devices/adverse effects
MH  - *Heart Transplantation
MH  - Risk Factors
MH  - Proportional Hazards Models
MH  - Treatment Outcome
MH  - Retrospective Studies
OTO - NOTNLM
OT  - adverse events
OT  - left ventricular assist device
OT  - psychosocial risk
OT  - sex differences
EDAT- 2023/06/29 01:08
MHDA- 2023/10/23 00:42
CRDT- 2023/06/28 19:16
PHST- 2022/10/05 00:00 [received]
PHST- 2023/06/14 00:00 [revised]
PHST- 2023/06/21 00:00 [accepted]
PHST- 2023/10/23 00:42 [medline]
PHST- 2023/06/29 01:08 [pubmed]
PHST- 2023/06/28 19:16 [entrez]
AID - S1053-2498(23)01920-4 [pii]
AID - 10.1016/j.healun.2023.06.013 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2023 Nov;42(11):1557-1568. doi: 
      10.1016/j.healun.2023.06.013. Epub 2023 Jun 26.