Paper
Friday, July 13, 2007
Quality of life as a predictor of one year survival among patients with implantable cardioverter defibrillators
Chi-Wen Kao, PhD, RN, School of Nursing, National Defense Medical Center, Taiwan, Taipei, Taiwan, Sue A. Thomas, PhD, RN, FAAN, School of Nursing, University of Maryland, Baltimore, MD, USA, and Erika Friedmann, PhD, School of Nursing, University of Maryland, Baltimore, MD, USA.
| Learning Objective #1: Recognize the quality of life in patients with implantable cardioverter defibrillators. |
| Learning Objective #2: Identify the relationship between quality of life and one year survival in patients with implantable cardioverter defibrillators. |
PURPOSE: This study aimed to examine the predictors of one year survival, and to determine the relationship between quality of life (QOL) and one year survival in patients with ICDs. METHOD: The study used the dataset from the Antiarrhythmic Versus Implanted Defibrillator (AVID) controlled clinical trial conducted by the National Institutes of Health (NIH), National Heart, Lung, and Blood Institute. The 507 patients randomly assigned to the ICD treatment were recruited in the analysis. The subjects were most male (78.3%), with mean age of 64.85±
10.81 years, and mean ejection fraction (EF) of 32.2±
13.45%. The QOL was measured by SF-36 at baseline, 3 months, 6 months, and 1 year follow-up and by Quality of Life Index-Cardiac Version (QLI-CV) at baseline and 1 year follow-up. The depression was evaluated by Mental Health Inventory-5 Items (MHI-5). Data were analyzed by descriptive statistics and logistic regression. RESULTS: The mean of total survival time for the ICD patients was 2.61±
1.24 years. A total of 54 patients died in the first year after ICD implantation, and 445 patients were survival one year after implantation. Four of the predictor variables were significant independent predictors of surviving more than one year after ICD implantation: receiving ACEI therapy (OR= 3.01; 95% Confidence Interval (CI), 1.275, 11.33), age (OR= 1.572; 95% CI, 1.03, 2.398), stress perception at baseline (OR= 1.289; 95% CI, 1.046, 1.589), and QLI-CV (OR= .314; 95% CI, .131,.753). Beyond the effect of bio-psycho-social factors, better QOL predicted more than one year survival [X2 (3, N= 299)= 8.392, p= .039]. The QLI-CV was a significant independent predictor of likelihood of surviving one year after ICD implantation (OR= .314; 95% CI, .131, .753). CONCLUSION: Quality of life is an important factor predicting one year survival in patients with ICDs.