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Prog Transplant ; 29(3): 230-238, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31146631

RESUMO

INTRODUCTION: The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a psychometric instrument designed to assess patient risk for transplant. We investigated the association between SIPAT scores and demographic data with psychosocial and medical outcomes within a diverse kidney/kidney-pancreas transplant population. DESIGN: The SIPAT was administered to all pretransplant candidates. A retrospective review of transplanted patients who had at least 6 months of follow-up was completed. RESULTS: The sample included 136 patients: male (n = 77 [57%]) with a mean age of 47 years old. Thirty-eight percent were black (n = 51), 55% had less than a high school education (n = 74), and 65% had low socioeconomic status (n = 89). Statistical difference was found among SIPAT scores and substance use and support system instability (P = .035, P = .012). Females (P = .012) and patients with a history of psychopathology (P = .002) developed or had a relapse of psychopathology following transplant. Patients with more than a high school education (P = .025) and who were less than 30 years (P = .026) had higher rejection incidence rates. Risk factors for rehospitalizations included Hispanic race, diabetes, and low socioeconomic status (P = .036, P = .038, P = .014). African American/Black and male patients had higher incidence of infection events (P = .032, P = .049). Mortality and treatment nonadherence were not significantly associated with SIPAT scores or demographic variables. CONCLUSION: The SIPAT was associated with posttransplant substance use and support system instability, while demographic variables were associated with the development and/or relapse of psychopathology, graft loss, rejection, infection events, and medical rehospitalizations. Revision of the SIPAT to include additional demographic components may lend to improved prediction of transplant outcomes.


Assuntos
Diabetes Mellitus/epidemiologia , Etnicidade/estatística & dados numéricos , Rejeição de Enxerto/epidemiologia , Transplante de Rim , Transtornos Mentais/epidemiologia , Transplante de Pâncreas , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transplantados/estatística & dados numéricos , Adulto , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Fatores Etários , Escolaridade , Etnicidade/psicologia , Feminino , Sobrevivência de Enxerto , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Humanos , Incidência , Infecções/epidemiologia , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Readmissão do Paciente/estatística & dados numéricos , Período Pré-Operatório , Psicometria , Estudos Retrospectivos , Classe Social , Apoio Social , Transplantados/psicologia , População Branca/psicologia , População Branca/estatística & dados numéricos
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