The value of Stanford integrated psychosocial assessment for transplantation (SIPAT) in prediction of clinical outcomes following left ventricular assist device (LVAD) implantation
The value of Stanford integrated psychosocial assessment for transplantation (SIPAT) in prediction of clinical outcomes following left ventricular assist device (LVAD) implantation
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DOI：
10.1016/j.hrtlng.2018.08.011
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发表时间：
2019-03-01
期刊：
影响因子：
2.8
通讯作者：
Adler, Eric
中科院分区：
文献类型：
--
作者：
Bui, Quan M.;Braun, Oscar O.;Adler, Eric
背景资料：斯坦福大学移植综合心理社会评估（SIPAT）是一种有效的移植人群心理社会评估工具。目的：我们评估了SIPAT在预测左心室辅助装置（LVAD）后结局方面的作用，包括累积再入院、传动系感染、泵故障、泵血栓形成、消化道出血、大出血、卒中和右心室衰竭。方法：这项回顾性研究纳入了美国一家学术机构的50名LVAD患者，这些患者在2015-2017年期间进行了植入前SIPAT评分。根据SIPAT评分将患者分为两组，将“优秀”/“良好”与“最低限度可接受”/“差”候选者分开。Poisson回归，使用SIPAT作为分类和连续变量，用于比较累积再入院的主要结局和LVAD并发症的次要结局的发生率。结果：患者队列主要为男性，93.5% vs 89.4%（p = 0.629），中位年龄为67.0岁vs 58.0岁（p = 0.037），计划目标治疗48.4% vs 68.4%（p = 0.242），低SIPAT组和高SIPAT组的中位LVAD随访时间分别为241 vs 379天（p = 0.10）。SIPAT是不是一个重要的预测累积再入院，但有较高的SIPAT评分和重大bleeding.Conclusion之间的关联：在这个单中心的回顾性研究中，SIPAT没有预测累积再入院。在临床实施之前，需要进一步研究来验证SIPAT。(C)2018爱思唯尔公司All rights reserved.
Background: The Stanford integrated psychosocial assessment for transplantation (SIPAT) is a validated psychosocial evaluation tool in the transplant population.Objective: We evaluated SIPAT in predicting post-left ventricular assist device (LVAD) outcomes, including cumulative re-admissions, driveline infections, pump malfunction, pump thrombosis, gastrointestinal bleeding, major bleeding, stroke and right ventricular failure.Methods: This retrospective study included 50 LVAD patients at an academic institution in the United States who had a pre-implant SIPAT score during the years 2015-2017. Patients were split into two groups based on SIPAT score, separating a "excellent"/"good" from a "minimally acceptable"/"poor" candidate. Poisson regression, using SIPAT as both a categorical and continuous variable, was used to compare the incidence rates of the primary outcome of cumulative re-admissions and secondary outcomes of LVAD complications.Results: The patient cohort was predominantly male 93.5% vs 89.4% (p = 0.629) with a median age of 67.0 vs 58.0 years (p = 0.037), planned destination therapy 48.4% vs 68.4% (p = 0.242) and median LVAD follow-up time of 241 vs 379 days (p = 0.10) in the low- and high-SIPAT groups, respectively. SIPAT was not a significant predictor for cumulative re-admissions, but there was an association between higher SIPAT scores and major bleeding.Conclusion: In this single-center retrospective study, SIPAT did not predict cumulative re-admissions. Further study is required to validate SIPAT before clinical implementation. (C) 2018 Elsevier Inc. All rights reserved.