Psychosocial Risk Impacts Mortality in Women After Liver Transplantation.
Psychosomatics
; 60(1): 56-65, 2019.
Article
en En
| MEDLINE
| ID: mdl-30122643
ABSTRACT
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 (pâ¯=â¯0.003) even after adjustments for age, marital status, and BMI. Women with ALD had a 2-fold increased hazard of death (pâ¯=â¯0.012). Increasing age was associated with increased risk of death for the cohort as a whole (pâ¯=â¯0.019) and for men (pâ¯=â¯0.014). In men, being married and BMI were marginally protective (pâ¯=â¯0.10 and pâ¯=â¯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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Apoyo Social
/
Salud Mental
/
Mortalidad
/
Trasplante de Hígado
/
Cirrosis Hepática Alcohólica
/
Neoplasias Hepáticas
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Psychosomatics
Año:
2019
Tipo del documento:
Article