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.

本研究的目的是确定老年晚期心力衰竭（HF）患者是否