The Impact of Race on Quality of Life of the Aged after Heart Transplant or Destination Therapy Mechanical Support

种族对心脏移植或目的地治疗机械支持后老年人生活质量的影响

• 批准号: 10282497
• 负责人: Jerian Dixon-Evans
• 金额: $ 6.94万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10282497
• 关键词: Address; Adult; Adverse event; Affect; African American; Age; Age-Years; Aging; Alaska Native; American Indians; Asians; Cardiac Surgery procedures; Cardiology; Cardiomyopathies; Cities; Clinical; Death Rate; Decision Making; Destinations; Devices; Disease; Ethnic Origin; Hawaiian population; Heart Transplantation; Heart failure; Implant; Incidence; Inequality; Interagency Registry for Mechanically Assisted Circulatory Support; Kansas; Knowledge; Literature; Mechanics; Medical; Minority; Modeling; National Institute on Aging; Operative Surgical Procedures; Outcome; Pacific Island Americans; Participant; Patient-Centered Care; Patients; Population; Postoperative Period; Preparation; Prevalence; Procedures; Psyche structure; Quality of life; Questionnaires; Race; Reporting; Research Personnel; Research Project Grants; Resources; Risk; Risk Factors; Site; Survival Rate; Symptoms; Time; Training; Transplant Recipients; Transplantation; aged; comparative effectiveness study; data resource; experience; health difference; health disparity; health related quality of life; improved; interest; left ventricular assist device; middle age; primary endpoint; prospective; racial difference; social

The purpose of this study is to determine whether older advanced heart failure (HF) patients who undergo destination therapy mechanical circulatory support (DT MCS), as compared to patients who undergo heart transplantation (HT), experience non-inferior change in overall health-related quality of life (HRQOL) and HRQOL domains (physical, mental, and social) by race from baseline to 1 year post-operatively. Advanced HF patients, 60-80 years of age, are an appropriate target group for this proposed study because they are receiving HTs and implant of MCS devices more frequently, and despite a greater risk for poor clinical outcomes, they have acceptable rates of survival. While studies have examined overall survival, few have considered HRQOL of older minority patients who undergo HT or DT MCS. MY proposed study may contribute to better patient-centered care of older minority advanced HF patients, by informing decision making and guiding strategies to enhance post-operative HRQOL. I will leverage the data resources of Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support? (SUSTAIN-IT) (National Institute on Aging # R01AG047416, 7/15/15 – 3/31/21). SUSTAIN-IT is a multi-site, observational, prospective, longitudinal, comparative effectiveness study. I will use a theoretical framework which models the influence of disease, treatment, adverse events, and symptoms on HRQOL to guide this proposed study. The primary aim is to determine whether older advanced HF patients who undergo DT MCS, as compared to patients who undergo HT (with or without MCS) experience non-inferior change in overall HRQOL (primary endpoint, using the heart failure-specific Kansas City Cardiomyopathy-12 questionnaire summary score), and HRQOL domains by race (white versus all minorities) from baseline to 1 year post-operatively. The secondary Aim is to determine whether race is a risk factor related to overall HRQOL (using the Kansas City Cardiomyopathy-12 heart-failure specific questionnaire summary score as the dependent variable), for patients who undergo DT MCS and HT at 1 year post-operatively.

这项研究的目的是确定年龄较大的晚期心力衰竭（HF）患者是否 谁接受了目的地治疗机械电路支持（DT MCS） 接受心脏移植（HT）的患者，整体上经历了非上限变化 与健康相关的生活质量（HRQOL）和HRQOL领域（身体，精神和社交） 术后1年的基线比赛。高级HF患者，60-80岁，是 这项拟议研究的适当目标组，因为他们正在接受HTS和植入 MCS设备更频繁，并且会出现更大的临床结果风险，它们具有 可接受的生存率。尽管研究检查了总体生存，但很少有人考虑 患有HT或DT MC的老年少数族裔患者的HRQOL。我建议的研究可能 通过通知 决策和指导策略以增强术后HRQOL。我将利用 维持老年人生活质量的数据资源：心脏移植或机械 支持？ （Sustain-IT）（国家老化研究所＃R01AG047416，7/15/15 - 3/31/21）。 sustain-it是多站点，观察性，前瞻性，纵向，比较效率 学习。我将使用一个理论框架，该框架模拟了疾病，治疗的影响， 不良事件和HRQOL的症状指导这项拟议的研究。主要目的是 与患者相比，确定年长的高级HF患者是否接受DT MCS 谁经历了HT（有或没有MCS）经历了整体HRQOL的非上限变化 （主要终点，使用特定于心力衰竭的堪萨斯城心肌病-12问卷 摘要得分），以及从基线到1的种族（白与所有少数民族）按种族（白人与所有少数民族） 术后年。次要目的是确定种族是否是与 总体HRQOL（使用堪萨斯城的心脏病 - 12 摘要得分作为因变量），对于接受DT MC和HT的患者1年 术后。