A longitudinal comparison of health-related quality of life in rural and urban recipients of left ventricular assist devices.
Windy W Alonso, Kenneth M Faulkner, Bunny J Pozehl and 3 others
PMID 32627852WHAT IT FOUND
After LVAD implantation, rural and urban recipients had similar heart failure and general quality of life scores over six months.
Rural recipients used emergency departments more often. Quality of life improved in both groups after implantation and ongoing specialty follow-up care.
Key findings
01Generic and heart failure-specific quality-of-life scores were not significantly different between rural and urban LVAD recipients at one, three, and six months after implantation.
02Quality of life increased substantially from baseline to 6 months after LVAD implantation and the required specialty follow-up care in both rural and urban recipients.
03Rural LVAD recipients visited the emergency department a mean of 1.28 times during the study, compared with 0.41 times for urban recipients.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small and mostly white and male, from one region, and rural recipients were over-represented, so results may not apply to more diverse populations. This was a secondary analysis, so the researchers could not account for factors such as sleep quality, social connectedness, transportation, or caregiver support. The rural group was small, which may limit the estimates of change over time. The generic measure was a single item, and the heart failure-specific quality-of-life domain had lower consistency than generally acceptable. The study did not randomise people to rural or urban status or to LVAD, so it cannot prove cause.
Declared interests
The parent PREMISE study was supported by NIH grant R01NR013492. The supplied text does not include a separate author conflict-of-interest declaration.
The easy way to misread this
Do not treat the quality-of-life improvement as proof that the LVAD device alone caused it. Recipients also needed ongoing specialty follow-up care, and this observational study cannot separate the device from that care.