Occupational therapy predicts post-operative left ventricular assist device (LVAD) self-care, hospital length of stay, and discharge disposition.

Purpose: Understanding LVAD self-care needs is important for candidacy decisions and care planning. This study investigated the association between pre-operative occupational therapy (OT) evaluations and post-operative LVAD self-care, length of stay (LoS), and discharge disposition. Methods: We retrospectively studied medical records of 100 LVAD recipients. OT pre-operative assessments included grip strength, Montreal Cognitive Assessment, Allen Cognitive Level Screen-5, daily activity performance, vision, and a performance-based LVAD battery management assessment (BMA). Ordinal logistic regression examined the association between OT pre-operative evaluation and actual post-operative LVAD self-care. Linear regression and random forest model classification models evaluated relative contributions of individual OT assessment items on LoS, LVAD self-care, and discharge disposition, respectively. Results: At post-implant discharge, 35% of patients were independent with LVAD self-care, 49% required some assistance, and 15% 24/7 assistance. OT pre-operative evaluations predicted post-operative LVAD self-care when controlling for sex, assistive device, setting acuity, and left ventricular ejection fraction (OR = 9.05, 95% CI: 2.70-30.29, Conclusion: Pre-operative OT evaluations of anticipated post-operative LVAD self-care, particularly vision and cognition assessments, were associated with actual post-operative LVAD self-care. Performance-based assessments provided insights for LoS and discharge disposition.