Posttraumatic Stress Symptoms in Patients on Ventricular Assist Device Support: Something to Worry About?

Psychosocial outcome in ventricular assist device (VAD) patients continues to merit evaluation including posttraumatic stress symptoms (PTSS).

A cross-sectional multicenter study collected data from 265 VAD patients, mean age was 59 ± 11yrs, 88% (N = 234) were male. Standardized PRO measures were applied; PTSS was assessed with the Breslau scale, supplemented by open-ended questions on "any traumatizing life events".

The weighted mean prevalence for patients reporting "any traumatizing event" was 43.0% (95% CI 37.0-49.2); prevalence for PTSS was 3.8% (95% CI 1.82-6.83). Traumatizing events were categorized into non-heart-related versus heart-related (both n = 57; 50%); heart surgery (n = 16) was most prominent. Oral intake of prescribed psychotropics (12.5%) was significantly higher in those with non-heart-related events (28.1% vs. 7.0%; p = 0.006). Female gender was associated with an OR of 1.703 (95%CI: 1.217-2.382; p = 0.002) for HADS_depression and oral psychotropics (OR 6.623, 95%CI: 2.009-21.830; p = 0.002). HRQoL was lower for those on psychotropics (p = 0.001). Patients who had experienced a trauma showed no differences in PTSS (p = 0.771), anxiety (p = 0.774), depression (p = 0.565), and HRQoL (p = 0.113).

A substantial proportion of VAD patients may have experienced traumatizing events; heart surgery was reported most prominently, may diminish the success of implantation, lead to PTSS, and warrants routine clinical screening of patients following VAD implantation.