Title |
Pre-transplant depression as a predictor of adherence and morbidities after orthotopic heart transplantation
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Published in |
Journal of Cardiothoracic Surgery, July 2017
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DOI | 10.1186/s13019-017-0626-0 |
Pubmed ID | |
Authors |
Maja Delibasic, Burhan Mohamedali, Nikola Dobrilovic, Jaishankar Raman |
Abstract |
Psychosocial factors are useful predictors of adverse outcomes after solid organ transplantation. Although depression is a known predictor of poor outcomes in patients who undergo orthotopic heart transplantation (OHT) and is actively screened for during pre-transplant evaluation, the effects of early identification of this entity on post-transplant outcomes are not clearly understood. The purpose of this study was to evaluate the impact of pre-transplant depression on outcomes after OHT. In this retrospective study, 51 patients that underwent psychosocial evaluation performed by a social worker prior to the transplant and followed up in our center post-transplant were enrolled. Patients were stratified by the presence/absence of depression during the initial encounter. Primary end-points were overall survival, 1st-year hospitalizations, overall hospitalizations, rejections, and compliance with medications and outpatient appointments. Depressed patients were 3.5 times more likely to be non-compliant with medications; RR = 3.5, 95% CI (1.2,10.2), p = 0.046 and had higher incidence of first year hospitalizations (4.7 ± 3.1 vs. 2.2 ± 1.9, p = 0.046), shorter time to first hospitalization 25 days (IQR 17-39) vs. 100 days (IQR 37-229), p = 0.001. Patients with depression also had higher overall hospitalizations (8.3 ± 4.4 vs. 4.6 ± 4.2, p = 0.025,) and higher number of admissions for infections (2.8 ± 1.3 vs. 1.5 ± 1.4, p = 0.018) compared to patients without depression. There were no statistically significant differences in total number of rejections or compliance with outpatient appointments. Kaplan-Meier survival analysis did not reveal differences between the two groups (mean 3705 vs. 3764 days, log-rank p = 0.52). Depression was a strong predictor of poor medication compliance and higher rates of hospitalization in transplant recipients. No difference in survival between depressed and non-depressed patients after OHT was noted. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 69 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 10 | 14% |
Student > Bachelor | 9 | 13% |
Researcher | 7 | 10% |
Student > Ph. D. Student | 7 | 10% |
Student > Doctoral Student | 6 | 9% |
Other | 6 | 9% |
Unknown | 24 | 35% |
Readers by discipline | Count | As % |
---|---|---|
Psychology | 13 | 19% |
Medicine and Dentistry | 11 | 16% |
Nursing and Health Professions | 7 | 10% |
Agricultural and Biological Sciences | 3 | 4% |
Neuroscience | 3 | 4% |
Other | 7 | 10% |
Unknown | 25 | 36% |