Psychosocial Risk Impacts Mortality in Women After Liver Transplantation
| Autor: | Nuria J. Thusius, Terry D. Schneekloth, Tanya M. Petterson, Adriana R. Vasquez, Mario J. Hitschfeld, Walter K. Kremers, Sheila G. Jowsey-Gregoire, Kymberly D. Watt, Shehzad K. Niazi, Praveena Narayanan, Teresa A. Rummans |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Adolescent medicine.medical_treatment Kaplan-Meier Estimate Liver transplantation Pact Medication Adherence Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine Arts and Humanities (miscellaneous) Liver Cirrhosis Alcoholic Risk Factors Internal medicine medicine Humans Psychology Mortality Life Style Applied Psychology Aged Proportional Hazards Models Retrospective Studies business.industry Liver Neoplasms Social Support Retrospective cohort study Middle Aged 030227 psychiatry Liver Transplantation Transplantation Psychiatry and Mental health Mental Health Cohort Marital status Female business Psychosocial Body mass index 030217 neurology & neurosurgery |
| Zdroj: | Psychosomatics. 60(1) |
| ISSN: | 1545-7206 |
| Popis: | Background Liver transplant candidates undergo psychosocial assessment as a component of their pretransplant evaluation. Global psychosocial assessment scales, including the Psychosocial Assessment of Candidates for Transplantation (PACT), capture and quantify these psychiatric and social variables. Objective Our primary aim was to assess for an association between global PACT score and survival in liver transplant recipients. Methods This retrospective cohort study examined records of all liver recipients at one U.S. Transplant Center from 2000 to 2012 with outcomes monitoring until 07/01/2016. We investigated for associations between the following variables and mortality: PACT score, age, gender, marital status, race, alcoholic liver disease (ALD), and body mass index (BMI). Statistical methods included Student's t-test, Wilcoxon rank sum test, chi-square, Fisher's exact test, Kaplan–Meier curve, and Cox proportional hazard models. Results Of 1040 liver recipients, 538 had a documented PACT score. Among these, PACT score was not associated with mortality. In women, a lower PACT score was associated with mortality (p = 0.003) even after adjustments for age, marital status, and BMI. Women with ALD had a 2-fold increased hazard of death (p = 0.012). Increasing age was associated with increased risk of death for the cohort as a whole (p = 0.019) and for men (p = 0.014). In men, being married and BMI were marginally protective (p = 0.10 and p = 0.13, respectively). Conclusions Transplant psychosocial screening scales, specifically the PACT, identify psychosocial burden and may predict post-transplant outcomes in certain populations. In female liver recipients, lower PACT scores and ALD were associated with a greater risk of post-transplant mortality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect