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Linda Njoroge, MD Advanced Heart Failure and Transplantation Fellow 2017-2018

Impact of Marital Status on LVAD Mortality: A Single Center Experience Linda Njoroge MD, Mohamed Khayata MD, Kevin Charnas, Paul Bate, Madison Edge, James White, Guilherme Oliveira MD, Mahazarin Ginwalla MD. Linda Njoroge, MD Advanced Heart Failure and Transplantation Fellow 2017-2018

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Linda Njoroge, MD Advanced Heart Failure and Transplantation Fellow 2017-2018

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  1. Impact of Marital Status on LVAD Mortality:A Single Center ExperienceLinda Njoroge MD, Mohamed Khayata MD, Kevin Charnas, Paul Bate, Madison Edge, James White, Guilherme Oliveira MD, MahazarinGinwalla MD • Linda Njoroge, MD • Advanced Heart Failure and Transplantation Fellow 2017-2018 • University Hospitals, Cleveland Medical Center • Case Western Reserve University

  2. Study Background • LVADs offer both longer survival and improvements in QoL for carefully selected patients with inotrope-dependent heart failure. • Family caregivers are particularly involved in LVAD therapy and are known to share feelings of anxiety, guilt and depression as well as have an increased sense of intimacy with the patients • The 2013 ISHLT guidelines for MCS recommend assessment of the burden of the caregiver during the selection process Feldman D, Pamboukian SV, Teuteberg JJ, et al. The 2013 International Society for Heart and Lung Transplantation Guidelines for mechanical circulatory support: Executive summary. J Heart Lung Transplant. 2013;32:157–187.

  3. Study Background • This emphasizes the importance of social support in achieving optimal outcomes with LVAD therapy. • We sought to investigate the effect of marital status on mortality outcomes in LVAD recipients at our center.

  4. Methods: • We collected retrospective data on BTT and DT LVAD patients implanted from 2007-2017 at our center. • Institutional Review Board approval was obtained prior to accessing data from the INTERMACS database. • A subset of 95 patients had complete follow-up data. • Marital status was based on patient self-report survey that patients complete annually as part of their care

  5. Methods: • Cox regression model for time to death and marital status was performed. • A Kaplan-Meier survival curve was generated for married vs non-married which included divorced, separated, widowed and domestic partner statuses.

  6. Results: • Overall survival in married LVAD recipients was 57% compared to 43% of non-married (p=0.45) • There was greater survival observed survival in the first year after implantation. This benefit persisted 2 years post-LVAD implantation.

  7. Results:

  8. Conclusion: • This study suggests a trend towards improved survival in married compared to non-married patients following the index hospitalization. • This may be related to consistency of social support in married patients. • This support is conferred in terms of response to LVAD alarms, driveline management including dressing changes, recognition of adverse events and presence during outpatient follow up. • Close monitoring of non-married patients should be considered.

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