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Original article

Vol. 145 No. 5152 (2015)

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

  • Annina Seiler
  • Josef Jenewein
  • Chantal Martin-Soelch
  • Lutz Goetzmann
  • Ilhan Inci
  • Walter Weder
  • Macé Schuurmans
  • Christian Benden
  • Angela Brucher
  • Richard Klaghofer
DOI
https://doi.org/10.4414/smw.2015.14236
Cite this as:
Swiss Med Wkly. 2015;145:w14236
Published
13.12.2015

Summary

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.

References

  1. Rodrigue JR, Baz MA, Kanasky WF Jr, MacNaughton KL. Does lung transplantation improve health-related quality of life? The University of Florida experience. J Heart Lung Transplant. 2005;24(6):755–63.
  2. Kugler C, Fischer S, Gottlieb J, Tegtbur U, Welte T, Goerler H, et al. Symptom experience after lung transplantation: impact on quality of life and adherence. Clin Transplant. 2007;21(5):590–6.
  3. Munro PE, Holland AE, Bailey M, Button BM, Snell GI. Pulmonary rehabilitation following lung transplantation. Transplant Proc. 2009;41(1):292–5.
  4. Yusen RD, Edwards LB, Kucheryavaya AY, Benden C, Dipchand AI, Dobbels F, et al. The Registry of the International Society for Heart and Lung Transplantation: Thirty-first Adult Lung and Heart-Lung Transplant Report-2014; Focus Theme: Retransplantation. J Heart Lung Transplant. 2014;33(10):1009–24.
  5. Swisstransplant, Annual Report 2013, 2013, Swisstransplant, Schweizerische Nationale Stiftung für Organspende und Transplantation: Bern, Switzerland. p. 1–43.
  6. Inci I, Schuurmans MM, Boehler A, Weder W. Zurich University Hospital lung transplantation programme: update 2012. Swiss Med Wkly. 2013;143:w13836.
  7. Swisstransplant Swisstransplant Annual Report 2014. 2015.
  8. Myaskovsky L, Dew MA, McNulty ML, Switzer GE, DiMartini AF, Kormos RL, et al. Trajectories of change in quality of life in 12-month survivors of lung or heart transplant. Am J Transplant. 2006;6(8):1939–47.
  9. Pinson CW, Feurer ID, Payne JL, Wise PE, Shockley S, Speroff T. Health-related quality of life after different types of solid organ transplantation. Ann Surg. 2000;232(4):597–607.
  10. Goetzmann L, Ruegg L, Stamm M, Ambühl P, Boehler A, Halter J, et al. Psychosocial profiles after transplantation: a 24-month follow-up of heart, lung, liver, kidney and allogeneic bone-marrow patients. Transplantation. 2008;86(5):662–8.
  11. Kugler C, Tegtbur U, Gottlieb J, Bara C, Malehsa D, Dierich M, et al. Health-related quality of life in long-term survivors after heart and lung transplantation: a prospective cohort study. Transplantation. 2010;90(4):451–7.
  12. Butler J, McCoin NS, Feurer ID, Speroff T, Davis SF, Chomsky DB, et al. Modeling the effects of functional performance and post-transplant comorbidities on health-related quality of life after heart transplantation. J Heart Lung Transplant. 2003;22(10):1149–56.
  13. Vermeulen KM, Ouwens JP, van der Bij W, de Boer WJ, Koëter GH, TenVergert EM. Long-term quality of life in patients surviving at least 55 months after lung transplantation. Gen Hosp Psychiatry. 2003;25(2):95–102.
  14. Vermuelen KM, van der Bij W, Erasmus ME, TenVergert EM. Long-term health-related quality of life after lung transplantation: different predictors for different dimensions. J Heart Lung Transplant. 2007;26(2):188–93.
  15. Santana MJ, Feeny D, Ghosh S, Lien DC. Patient-reported outcome 2 years after lung transplantation: does the underlying diagnosis matter? Patient Relat Outcome Meas. 2012;3:79–84.
  16. Kugler C, Fischer S, Gottlieb J, Welte T, Simon A, Haverich A, et al. Health-related quality of life in two hundred-eighty lung transplant recipients. J Heart Lung Transplant. 2005;24(12):2262–8.
  17. Gerbase MW, Spiliopoulos A, Rochat T, Archinard M, Nicod LP.. Health-related quality of life following single or bilateral lung transplantation: a 7-year comparison to functional outcome. Chest. 2005;128(3):1371–8.
  18. Dew MA, DiMartini AF, DeVito Dabbs AJ, Fox KR, Myaskovsky L, Posluszny DM, et al. Onset and risk factors for anxiety and depression during the first 2 years after lung transplantation. Gen Hosp Psychiatry. 2012;34(2):127–38.
  19. Klaghofer R, Braehler E. Construction and validation of a shor form of the SCL-90-R. Z Klin Psychol Psychiatr Psychother. 2001;49(2):115–24.
  20. Rosen CS, Drescher KD, Moos RH, Finney JW, Murphy RT, Gusman F. Six- and ten-item indexes of psychological distress based on the Symptom Checklist-90. Assessment. 2000;7(2):103–11.
  21. Franke GH, SCL-90-R. Die Symptomcheckliste von Derogatis – Deutsche Version. Manual.1995, Göttingen: Beltz.
  22. EuroQol Group, EuroQol – a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199–208.
  23. Hinz A, Klaiberg A, Brähler E, König HH. [The Quality of Life Questionnaire EQ-5D: modelling and norm values for the general population.] Psychother Psychosom Med Psychol. 2006;56(2):42–8. German.
  24. Vaquero Barrios JM, Redel Montero J, Santos Luna F. Comorbidities impacting on prognosis after lung transplant. Arch Bronconeumol. 2014;50(1):25–33.
  25. IBM Corp, IBM SPSS Statistics for Windows, Version 22.02013, Armonk, NY: IBM Corp.
  26. Ward JH. Hierarchical Grouping to Optimize an Objective Function. J Am Stat Assoc. 1963;58(301):236–44.
  27. Hair JF, Black WC. Cluster analysis., in In Reading and Understanding More Multivariate Statistics. L.G. Grimm, P.R. Yarnold, eds.2000, American Psychological Association: Washington DC. p. 147–205.
  28. Cohen L, Littlefield C, Kelly P, Maurer J, Abbey S. Predictors of quality of life and adjustment after lung transplantation. Chest. 1998;113(3):633–44.
  29. Baranyi A, Krauseneck T, Rothenhausler HB. Overall mental distress and health-related quality of life after solid-organ transplantation: results from a retrospective follow-up study. Health Qual Life Outcomes. 2013;11:15.
  30. Dew MA, DiMartini AF, DeVito Dabbs AJ, Fox KR, Myaskovsky L, Posluszny DM, et al. Onset and risk factors for anxiety and depression during the first 2 years after lung transplantation. Gen Hosp Psychiatry. 2012;34(2):127–38.
  31. Schumacher A, Sauerland C, Silling G, Berdel WE, Stelljes M.. Resilience in patients after allogeneic stem cell transplantation. Support Care Cancer. 2014;22(2):487–93.
  32. DeVito Dabbs A, Terhorst L, Song MK, Shellmer DA, Aubrecht J, Connolly M, et al. Quality of recipient-caregiver relationship and psychological distress are correlates of self-care agency after lung transplantation. Clin Transplant. 2013;27(1):113–20.
  33. Archonti C, D'Amelio R, Klein T, Schäfers HJ, Sybrecht GW, Wilkens H. [Physical quality of life and social support in patients on the waiting list and after a lung transplantation.] Psychother Psychosom Med Psychol. 2004;54(1):17–22. German.
  34. Vasiliadis HM, Collet JP, Poirier C. Health-related quality of life determinants in lung transplantation. J Heart Lung Transplant. 2006;25(2):226–33.
  35. Rodrigue JR, Baz MA. Are there sex differences in health-related quality of life after lung transplantation for chronic obstructive pulmonary disease? J Heart Lung Transplant. 2006;25(1):120–5.
  36. Goetzmann L, Irani S, Schwegler K, Stamm M, Bricman R, Buddeberg C, et al. Distress and alexithymia in lung recipients – psychosocial strains and associations with chronic allograft dysfunction. Swiss Med Wkly. 2010;140(25-26):382–7.
  37. Havik OE, Sivertsen B, Relbo A, Hellesvik M, Grov I, Geiran O, et al. Depressive symptoms and all-cause mortality after heart transplantation. Transplantation. 2007;84(1):97–103.
  38. Sirri L, Potena L, Masetti M, Tossani E, Magelli C, Grandi S. Psychological predictors of mortality in heart transplanted patients: a prospective, 6-year follow-up study. Transplantation. 2010;89(7):879–86.
  39. Rosenberger EM, DiMartini AF, DeVito Dabbs AJ, Bermudez CA, Pilewski JM, Toyoda Y, et al. Psychiatric Predictors of Long-Term Transplant-Related Outcomes in Lung Transplant Recipients. Transplantation. 2015. [Epub ahead of print.]

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