Patients' sex and emotional support as predictors of death and clinical deterioration in the waiting for a new heart study: results from the 1-year follow-up.
Prog Transplant
; 21(2): 106-14, 2011 Jun.
Article
en En
| MEDLINE
| ID: mdl-21736238
ABSTRACT
CONTEXT Little is known about the role of patient's sex and emotional support in the prognosis of heart transplant candidates. OBJECTIVE:
To examine patient's sex and emotional support as predictors of outcomes in the Waiting for a New Heart Study. DESIGN, SETTING, ANDPARTICIPANTS:
The Waiting for a New Heart Study is a prospective observational study of 318 patients (18% female) newly added to the waiting list for a heart transplant. Demographic, medical, psychosocial characteristics (including social support [ENRICHD Social Support Index; high vs. low support]) were assessed at the time of wait-listing. Main Outcomes-Time until death/delisting due to deteriorated tealth, considering competing outcomes (e.g., transplantation) during the first 12 months after wait-listing were analyzed via cause-specific Cox proportional hazard models.RESULTS:
By 12 months, 32 men (12%) and 10 women (17%) had died/deteriorated. Medical risk was comparable across sexes. More men than women reported low emotional support (20.4% vs. 8.6%) and being a past or current smoker (80.4% vs. 56.9%). More women than men had low vocational level (93.1% vs. 69.6%; all P values < .05). With medical risk and other confounding variables controlled for, female sex significantly increased risk of death/deterioration (hazard ratio, 2.30; 95% confidence interval, 1.04-5.12; P = .04); low emotional support further tended to increase the risk for this outcome (P = .07). As none of the 5 women with low emotional support had reached this end point, analyses were performed in the male sample and revealed that men with low emotional support were more than twice as likely to die/deteriorate than were men with high support (hazard ratio, 2.23; 95% confidence interval, 1.04-4.82; P = .04).CONCLUSION:
Women had worse survival while awaiting a heart transplant than men had, independent of confounding variables. Even though emotional support may be an important buffer for men, protective factors for women warrant further investigation with larger samples and/or longer follow-ups.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Apoyo Social
/
Listas de Espera
/
Trasplante de Corazón
/
Insuficiencia Cardíaca
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Prog Transplant
Asunto de la revista:
ENFERMAGEM
/
TRANSPLANTE
Año:
2011
Tipo del documento:
Article
País de afiliación:
Estados Unidos