TY - JOUR
T1 - Psychosocial predictors of mortality following lung transplantation
AU - Smith, P. J.
AU - Blumenthal, J. A.
AU - Trulock, E. P.
AU - Freedland, K. E.
AU - Carney, R. M.
AU - Davis, R. D.
AU - Hoffman, B. M.
AU - Palmer, S. M.
N1 - Funding Information:
This research was supported by Grant No. HL 065503 from the National Institutes of Health, Bethesda, MD.
Publisher Copyright:
Copyright © 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Lung transplantation has become an increasingly common treatment for patients with end-stage lung disease. Few studies have examined psychosocial risk factors for mortality in transplant recipients, despite evidence suggesting that elevated levels of negative affect are associated with greater mortality following major cardiac surgery. We therefore examined the relationship between negative affect early after lung transplantation and long-term survival in a sample of 132 lung transplant recipients (28 cystic fibrosis, 64 chronic obstructive pulmonary disease, 26 idiopathic pulmonary fibrosis, 14 other) followed for up to 13.5 years (median 7.4 years) following transplantation. Patients underwent both medical and psychosocial assessments 6 months following transplantation, which included the Beck Depression Inventory-II (BDI-II), Spielberger Anxiety Inventory, and General Health Questionnaire (GHQ). Over the course of follow-up, 80 (61%) participants died. Controlling for demographic factors, native lung disease, disease severity, family income, education level, social support, and frequency of posttransplant rejection, elevated symptoms of depression (BDI-II: HR = 1.31, p = 0.011) and distress (GHQ: HR = 1.28, p = 0.003) were associated with increased mortality. Higher levels of depression and general distress, but not anxiety, measured 6 months following lung transplantation are associated with increased mortality, independent of background characteristics and medical predictors. Lung transplant recipients with elevated levels of depression and psychological distress following transplant exhibit greater long-term mortality rates.
AB - Lung transplantation has become an increasingly common treatment for patients with end-stage lung disease. Few studies have examined psychosocial risk factors for mortality in transplant recipients, despite evidence suggesting that elevated levels of negative affect are associated with greater mortality following major cardiac surgery. We therefore examined the relationship between negative affect early after lung transplantation and long-term survival in a sample of 132 lung transplant recipients (28 cystic fibrosis, 64 chronic obstructive pulmonary disease, 26 idiopathic pulmonary fibrosis, 14 other) followed for up to 13.5 years (median 7.4 years) following transplantation. Patients underwent both medical and psychosocial assessments 6 months following transplantation, which included the Beck Depression Inventory-II (BDI-II), Spielberger Anxiety Inventory, and General Health Questionnaire (GHQ). Over the course of follow-up, 80 (61%) participants died. Controlling for demographic factors, native lung disease, disease severity, family income, education level, social support, and frequency of posttransplant rejection, elevated symptoms of depression (BDI-II: HR = 1.31, p = 0.011) and distress (GHQ: HR = 1.28, p = 0.003) were associated with increased mortality. Higher levels of depression and general distress, but not anxiety, measured 6 months following lung transplantation are associated with increased mortality, independent of background characteristics and medical predictors. Lung transplant recipients with elevated levels of depression and psychological distress following transplant exhibit greater long-term mortality rates.
UR - http://www.scopus.com/inward/record.url?scp=84956911992&partnerID=8YFLogxK
U2 - 10.1111/ajt.13447
DO - 10.1111/ajt.13447
M3 - Article
C2 - 26366639
AN - SCOPUS:84956911992
SN - 1600-6135
VL - 16
SP - 271
EP - 277
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 1
ER -