Journal Article

Pre-Transplant Depression Is Associated with Length of Hospitalization, Discharge Disposition, and Survival after Liver Transplantation

Good, Chester B., Jazwinski, Alison, Jonassaint, Naudia, Mankaney, Gautham, Rogal, Shari S., Chidi, Alexis, Shaikh, Obaid, Udawatta, Viyan, DiMartini, Andrea, Bielefeldt, Klaus, Chinman, Matthew, Hughes, Christopher, Fontes, Paulo, Humar, Abhinav, Zickmund, Susan

2016

Overview

Depression after liver transplantation has been associated with decreased survival, but the effects of pre-transplant depression on early and late post-transplant outcomes remain incompletely evaluated. We assessed all patients who had undergone single-organ liver transplantation at a single center over the prior 10 years. A diagnosis of pre-transplant depression, covariates, and the outcomes of interest were extracted from the electronic medical record. Potential covariates included demographics, etiology and severity of liver disease, comorbidities, donor age, graft type, immunosuppression, and ischemic times. In multivariable models adjusting for these factors, we evaluated the effect of pre-transplant depression on transplant length of stay (LOS), discharge disposition (home vs. facility) and long-term survival. Among 1115 transplant recipients with a median follow-up time of 5 years, the average age was 56±11 and MELD was 12±9. Nineteen percent of the study population had a history of pre-transplant depression. Pre-transplant depression was associated with longer LOS (median = 19 vs. 14 days, IRR = 1.25, CI = 1.13,1.39), discharge to a facility (36% vs. 25%, OR 1.70,CI = 1.18,2.45), and decreased survival (HR = 1.54,CI = 1.14,2.08) in this cohort, accounting for other potential confounders. In conclusion, pre-transplant depression was significantly associated with longer transplant length of stay, discharge to a facility, and mortality in this cohort.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Alcohol / Analysis / Antidepressants / Biology and Life Sciences / Child & adolescent psychiatry / Chronic obstructive pulmonary disease / Comorbidity / Demographics / Demography / Depression (Mood disorder) / Depression - psychology / Diabetes / Discharge / Electronic medical records / Etiology / Female / Gastroenterology / Health care policy / Heart failure / Hemodialysis / Hepatology / Humans / Immunosuppression / Immunotherapy / Internal medicine / Ischemia / Length of Stay / Liver / Liver cancer / Liver diseases / Liver transplantation / Liver Transplantation - psychology / Liver transplants / Male / Medical electronics / Medical records / Medical research / Medicine and Health Sciences / Mental depression / Middle Aged / Mortality / Nutrition / Older people / Patient Discharge / Patient outcomes / Patients / Population studies / Preventive medicine / Quality of life / Retrospective Studies / Studies / Surgery / Survival / Survival Analysis / Systematic review / Transplantation / Transplants & implants / Treatment Outcome