Comparing mental health and substance use disorders in patients receiving durable VADs versus transplants: A TriNetX database analysis

Ventricular assist device (VAD) and cardiac transplant patients experience significant strain on their physical and mental wellbeing postoperatively. Mental health and substance use disorders (MHDs and SUDs) have substantial effects on the quality of life and compliance of transplant and VAD patients. In this study, we compare and characterize MHDs and SUDs between VAD and cardiac allograft patients and transplant list patients with and without VADs. This study compares the incidence of MHDs and SUDs between VAD and cardiac transplant patients. Cohorts were defined using ICD-10 codes in TriNetX, a large public database. Patient characteristics were matched by using propensity score matching. Incidence was analyzed using the log-rank test. Statistical significance was set at p < 0.05. Survival analysis showed a statistically significant impact of adjustment disorder, nicotine dependence, and mood disorder in VAD patients as compared to cardiac allograft recipients. Depression and opioid use disorder had a significantly higher incidence in post-transplant patients compared to their VAD counterparts. Survival analysis showed that PTSD and mood disorder had a statistically significant effect on the patients waiting on transplant wait list without VADs as compared to those with VADs. MHDs and SUDs have profound implications on quality of life, survival, and medication compliance. The incidence of MHDs and SUDs differed between VAD versus cardiac transplant patients as well as the patients on the transplant waitlist with and without VADs. Mental health resources should be tailored to address risk factors that may be unique to each group of patients.