Estado de salud de pacientes con trasplante hepático por enfermedad relacionada con el consumo de alcohol vs. otras etiologías: estudio de cohortes / Health status of patients with liver transplantation by alcohol-related disease vs another etiology: a cohort study

Objetivo: Estudiar el estado de salud de un grupo de pacientes con trasplante hepático (TH) por enfermedad relacionada con el consumo de alcohol vs. otras etiologías, antes y después del trasplante. Método: Estudio longitudinal de cohortes en pacientes trasplantados hepáticos desde noviembre de 2019 hasta julio de 2022. Se incluyeron pacientes atendidos para un primer TH tanto electivo como urgente en la Unidad de Trasplantes de un hospital. Se excluyeron aquellos pacientes que ya portaban un órgano trasplantado y aquellos que necesitaron un re-TH en el primer mes tras el primer trasplante. Se recogieron variables sociodemográficas y clínicas, Model for End-Stage Liver Disease (MELDNa), índice de fragilidad hepática (LFI), efectos emocionales-conductuales del trasplante, nivel de ansiedad y depresión. En el análisis estadístico se utilizaron las pruebas de X2 de Pearson, t de Student, U de Mann-Whitney y el signo de Wilcoxon. Resultados: La muestra fue n = 67 pacientes trasplantados hepáticos, con una edad promedio de 56,37 años, siendo 67,2% hombres y 39% por enfermedad hepática relacionada con el alcohol (EHRA). De todos los pacientes incluidos, 9% fueron trasplantes urgentes. El consumo de alcohol se asoció con una mayor edad, una alta tasa de fragilidad hepática y una situación laboral no activa. La etiología alcohólica se correlacionó con una mayor preocupación durante los primeros seis meses después del trasplante de hígado. Conclusión: Existen diferencias en el estado de salud de los pacientes trasplantados hepáticos por EHRA vs. otra etiología. Las enfermeras deben considerar la etiología de la enfermedad hepática para orientar los cuidados y las intervenciones durante todo el proceso de trasplante.(AU)

Aim: To study the health status of a group of patients with liver transplantation by alcohol-related disease vs another etiology before and after the transplantation. Method: Longitudinal cohort study of liver transplant patients from November 2019 to July 2022. Adult patients attended in the unit of transplantation of a hospital for a first liver transplant, both elective and urgent, were included. Patients who already had a transplanted organ and those who required liver re-transplantation in the first month after the first transplant were excluded. Sociodemographic and clinical variables, MELDNa, liver frailty index, emotional-behavioral effects of transplantation, level of anxiety and depression were collected. Pearson's chi-square, Student's t, Mann-Whitney U, and Wilcoxon sign tests were used for statistical analysis. Results: The sample was n = 67 liver transplant patients with a mean age of 56.37 years, 67.2% being men and 39% due to alcohol-related liver disease. 9% of all included patients were urgent transplants. Alcohol consumption was associated with older age, a high rate of liver frailty, and a non-active work situation. Alcoholic etiology correlated with increased concern during the first six months after liver transplantation. Conclusion: There are differences in the health status between liver transplant patients for alcohol-related liver disease vs other etiology. Nurses must consider the etiology of liver disease to guide care and interventions throughout the transplant process.(AU)

Health status of patients with liver transplantation by alcohol-related disease vs another etiology: A cohort study.

AIM: To study the health status of a group of patients with liver transplantation by alcohol-related disease vs another etiology before and after the transplantation. METHOD: Longitudinal cohort study of liver transplant patients from November 2019 to July 2022. Adult patients attended in the unit of transplantation of a hospital for a first liver transplant, both elective and urgent, were included. Patients who already had a transplanted organ and those who required liver re-transplantation in the first month after the first transplant were excluded. Sociodemographic and clinical variables, MELDNa, liver frailty index, emotional-behavioral effects of transplantation, level of anxiety and depression were collected. Pearson's chi-square, Student's t, Mann-Whitney U, and Wilcoxon sign tests were used for statistical analysis. RESULTS: The sample was n = 67 liver transplant patients with a mean age of 56.37 years, 67.2% being men and 39% due to alcohol-related liver disease. 9% of all included patients were urgent transplants. Alcohol consumption was associated with older age, a high rate of liver frailty, and a non-active work situation. Alcoholic etiology correlated with increased concern during the first six months after liver transplantation. CONCLUSION: There are differences in the health status between liver transplant patients for alcohol-related liver disease vs other etiology. Nurses must consider the etiology of liver disease to guide care and interventions throughout the transplant process.

Análisis del impacto del trasplante hepático como condicionante de salud / Analysis of the impact of liver transplantation as a condition of health

Objetivo: Analizar el impacto que el trasplante hepático ha tenido en el paciente como condicionante de su estado de salud. Método: Se realizó un estudio prospectivo, cuya muestra la formaron aquellos pacientes trasplantados hepáticos en el Hospital General Universitario Gregorio Marañón desde noviembre 2019 hasta agosto 2021. Se utilizaron la escala hospitalaria de ansiedad y depresión, el Modelo para enfermedad hepática en estadio terminal sodio, el índice de fragilidad hepática y el cuestionario efectos del trasplante. Se utilizaron la prueba t de Student para las variables continuas y la prueba de chi-cuadrado para las categóricas. Para aquellas muestras no paramétricas se utilizaron el signo de Wilcoxon, U de Mann-Whitney y Kruskal-Wallis. Resultados: La muestra la conformaron 60 pacientes con una media de edad de 55,68 años, siendo el 70% hombres. La puntuación media de ansiedad y depresión de los pacientes mejoró significativamente tras el trasplante hepático. El impacto de la salud física resultó en que aquellos pacientes con un mayor índice del Modelo para enfermedad hepática en estadio terminal sodio se correlacionaron con un mayor sentimiento de culpa tras el trasplante. Además, una mayor adherencia al tratamiento inmunosupresor se correlacionó directamente con una mayor revelación e inversamente con la culpa, tras el trasplante. Conclusión: El trasplante hepático es un proceso que impacta en la salud de los pacientes. Aquellos pacientes que llegan al trasplante con una situación física más deteriorada presentan una mayor culpa tras el trasplante. Dicho impacto se correlaciona inversamente con la adherencia al tratamiento inmunosupresor. Las enfermeras deben intervenir en dichos pacientes para reducir el impacto en la adherencia al tratamiento.(AU)

Aim: To analyse the impact that liver transplantation has had on the patient as a condition of their health. Method: A prospective study was carried out, the sample of which was made up of liver transplant patients at the Gregorio Marañón General University Hospital from November 2019 to August 2021. The hospital anxiety and depression scale, the Model for End-stage liver disease sodium and liver fragility index and the Transplant Effects Questionnaire Spanish were used. The data were analysed using descriptive statistics. The Student's t test was used for continuous variables and the chi-square test for categorical variables. For non-parametric samples, the Wilcoxon, Mann-Whitney U test and Kruskal-Wallis's sign were used. Results: The sample was made up of 60 patients with a mean age of 55.68 years, 70% being men. The mean anxiety and depression scores of the patients improved significantly after liver transplantation. The impact of physical health resulted that those patients with a higher Model for End-stage liver disease sodium were correlated with a greater feeling of guilt after transplantation. Furthermore, greater adherence to immunosuppressive treatment was directly correlated with greater disclosure and inversely with guilt, after transplantation. Conclusion: Liver transplantation is a process that impacts the health of patients. Those patients who arrive at the transplant with a more deteriorated physical situation present a greater guilt after the transplant. This impact is inversely correlated with adherence to immunosuppressive treatment. Nurses should intervene in such patients to reduce the impact on adherence to treatment.(AU)

Analysis of the impact of liver transplantation as a condition of health.

AIM: To analyse the impact that liver transplantation has had on the patient as a condition of their health. METHOD: A prospective study was carried out, the sample of which was made up of liver transplant patients at the Gregorio Marañón General University Hospital from November 2019 to August 2021. The hospital anxiety and depression scale, the Model for End-stage liver disease sodium and liver fragility index and the Transplant Effects Questionnaire Spanish were used. The data were analysed using descriptive statistics. The student's t-test was used for continuous variables and the chi-square test for categorical variables. For non-parametric samples, the Wilcoxon, Mann-Whitney U test and Kruskal-Wallis's sign were used. RESULTS: The sample was made up of 60 patients with a mean age of 55.68 years, 70% being men. The mean anxiety and depression scores of the patients improved significantly after liver transplantation. The impact of physical health resulted that those patients with a higher Model for End-stage liver disease sodium were correlated with a greater feeling of guilt after transplantation. Furthermore, greater adherence to immunosuppressive treatment was directly correlated with greater disclosure and inversely with guilt, after transplantation. CONCLUSION: Liver transplantation is a process that impacts the health of patients. Those patients who arrive at the transplant with a more deteriorated physical situation present a greater guilt after the transplant. This impact is inversely correlated with adherence to immunosuppressive treatment. Nurses should intervene in such patients to reduce the impact on adherence to treatment.