Change in Patient-reported Outcomes after Implantable Cardioverter-defibrillator

Sandra Lauck


Purpose: To study the change in patient-reported outcomes (PROs) in the first six months following implantable cardioverter-defibrillator (ICD) surgery to identify the direction and rate of change, explore individual trajectories of change, and identify predictors of those trajectories.

Methods: The study was grounded in the Wilson and Cleary conceptual framework of quality of life. Using a prospective, longitudinal study design, measurements of patient-reported physical, mental and social health status were obtained prior to ICD implantation, and 2, 3, and 6 months following implantation. Individual growth modelling was conducted to analyse change within individuals and between groups.

Results: Data were initially obtained from 171 people (55.5% response rate). Follow-up measures were obtained from 149 people at 1-month, 140 at 2-months, and 139 at 6-months after implantation (81.3% completion rate). Participants had differing physical, mental, and social PROs at baseline and, on average, demonstrated improvement in most indicators. There was significant individual variability in most of the studied PROs. Women reported worse PROs initially (relative mean gender difference ranged from 4.5% to 24.7% for 6 of the 12 indicators). Yet, the women’s rates of improvement were significantly faster than those of men. Women equalled or exceeded the men’s PROs at 6-month follow-up (relative mean difference ranged from 4.5% to 10.4%).

Conclusions: Clinically important improvements were noted in most PROs in the first 6 months. Men and women had different trajectories of change, and may benefit from gender-specific, appropriately timed, and targeted interventions to facilitate recovery and adaptation to living with an ICD.


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