Predictors of Physical Functional Disability at 5 to 6 Years after Heart Transplantation

• Published in: The Journal of heart and lung transplantation Vol. 24; no. 12; pp. 2279 - 2285
• Main Authors: Grady, Kathleen L., Naftel, David C., Kirklin, James K., White-Williams, Connie, Kobashigawa, Jon, Chait, Julie, Young, James B., Pelegrin, Dave, Patton-Schroeder, Kim, Rybarczyk, Bruce, Daily, Jason, Piccione, William, Heroux, Alain
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.12.2005; Elsevier Science
• Subjects: Activities of Daily Living; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Disabled Persons - classification; Female; Follow-Up Studies; Health Status; Heart Transplantation - rehabilitation; Humans; Male; Medical sciences; Middle Aged; Prognosis; Self Concept; Severity of Illness Index; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Heart; Disability; Treatment; Respiratory disease; Predictor; Surgery; Prediction; Graft; Cardiovascular disease; Transplantation; Predictive factor; Homotransplantation
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2005.05.007

Few reports were found in the literature that examined predictors of physical functional disability after heart transplantation. Therefore, the purpose of this study was to (1) describe physical functional disability, (2) identify differences in physical functional disability by demographic and clinical variables, and (3) identify predictors of physical functional disability at 5 to 6 years after heart transplantation. A nonrandom sample of 311 patients (approximately 60 years of age, 78% male, and 90% Caucasian) who were 5 to 6 years post-heart transplantation were investigated. Patients completed 8 reliable and valid quality-of-life instruments via self-report. Data analyses included descriptive statistics, chi-square, independent t-tests, correlations, and stepwise multiple regression. Level of significance was set at p = 0.05. The level of physical functional disability was low at 5 to 6 years after heart transplantation, yet 59% of patients reported having physical disability. Women experienced more functional disability than men, and patients with comorbidities (i.e., diabetes mellitus and orthopedic problems) experienced more functional disability than patients without these comorbidities. At 5 to 6 years after heart transplantation, 70% of variance in physical functional disability was explained by activities of daily living, symptoms, comorbidities, psychologic status, and resource utilization variables. At 5 to 6 years after heart transplantation, most patients experienced low levels of physical functional disability. Differences in physical functional disability were identified by both demographic characteristics and clinical variables. Predictors of physical functional disability included activities of daily living and symptoms, and clinical, psychologic, and resource utilization variables. Knowledge of factors related to physical disability long-term after heart transplantation provides direction for the development of strategies to assist patients to reduce their level of disability or function adequately despite their disability.