Post-transplant outcome-clusters of psychological distress and health-related quality of life in lung transplant recipients

Swiss Med Wkly. 2015 Dec 28:145:w14236. doi: 10.4414/smw.2015.14236. eCollection 2015.

Abstract

Questions under study: To (1) assess distinct clusters of psychological distress and health-related quality of life during the first 6 months following lung transplantation; (2) identify patients with poor psychosocial outcomes; and (3) determine potential predictors regarding psychological distress and health-related quality (HRQoL) of life at 6 months post-transplant.

Methods: A total of 40 patients were examined for psychological distress (Symptom Checklist short version-9) and quality of life (EuroQOL five-dimension health-related quality of life questionnaire) during their first 6 months post-transplant. Hierarchical cluster analyses were performed to identify specific types of post-transplant outcomes in terms of psychological distress and HRQoL over the first six post-transplant months. Correlational analyses examined medical and psychosocial predictors of the outcome at 6 months post-transplant.

Results: Three distinctive clusters were identified, summarizing either groups of patients with (1) optimal (35%), (2) good (42%), and (3) poor outcome-clusters (23%). The latter tended to be older, to suffer from more severe disease, to have more co-morbidities, to have had a prolonged intensive care unit and/or hospital stay, to have more hospital admissions and were more frequently treated with antidepressants post-transplant. Disease severity, length of stay, quality of life two weeks post-transplant, hospital admissions and use of antidepressants were strong predictors of psychological distress and impaired health-related quality of life at six months of follow-up.

Conclusion: Almost a quarter of the investigated patients suffered from elevated distress and substantially impaired HRQoL, with no improvements over time. Results underscore the psychosocial needs of patients with poor post-transplant outcomes.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Comorbidity
  • Female
  • Humans
  • Longitudinal Studies
  • Lung Transplantation*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Quality of Life / psychology*
  • Stress, Psychological / diagnosis*
  • Switzerland
  • Transplant Recipients / psychology*
  • Young Adult