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Aufsatz zugänglich unter
URN: urn:nbn:de:hbz:385-11139
URL: http://ubt.opus.hbz-nrw.de/volltexte/2017/1113/


Role of depression and social isolation at time of waitlisting for survival 8 years after heart transplantation

Spaderna, Heike ; Zittermann, Armin ; Reichenspurner, Hermann ; Ziegler, Corinna ; Smits, Jacqueline ; Weidner, Gerdi

Originalveröffentlichung: (2017) Journal of the American Heart Association
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SWD-Schlagwörter: Herztransplantation , Depression , Zeit , Isolation <Soziologie> , Wartezeit , Überleben
Freie Schlagwörter (Englisch): depression , heart failure , psychology and behaviorsocial isolation , social contactssurvival , analysistransplantation
Institut: Psychologie
DDC-Sachgruppe: Medizin
Sonstige beteiligte Institution: The publication was funded by the Open Access Fund of Universität Trier and the German Research Foundation (DFG)
Dokumentart: Aufsatz
Sprache: Englisch
Erstellungsjahr: 2017
Publikationsdatum: 20.12.2017
Bemerkung: DOI: https://doi.org/10.1161/JAHA.117.007016
Kurzfassung auf Englisch: Background: We evaluated depression and social isolation assessed at time of waitlisting as predictors of survival in heart transplant (HTx) recipients.

Methods and Results: Between 2005 and 2006, 318 adult HTx candidates were enrolled in the Waiting for a New Heart Study, and 164 received transplantation. Patients were followed until February 2013. Psychosocial characteristics were assessed by questionnaires. Eurotransplant provided medical data at waitlisting, transplantation dates, and donor characteristics; hospitals reported medical data at HTx and date of death after HTx. During a median follow‐up of 70 months (<1–93 months post‐HTx), 56 (38%) of 148 transplanted patients with complete data died. Depression scores were unrelated to social isolation, and neither correlated with disease severity. Higher depression scores increased the risk of dying (hazard ratio=1.07, 95% confidence interval, 1.01, 1.15, P=0.032), which was moderated by social isolation scores (significant interaction term; hazard ratio = 0.985, 95% confidence interval, 0.973, 0.998; P=0.022). These findings were maintained in multivariate models controlling for covariates (P values 0.020–0.039). Actuarial 1‐year/5‐year survival was best for patients with low depression who were not socially isolated at waitlisting (86% after 1 year, 79% after 5 years). Survival of those who were either depressed, or socially isolated or both, was lower, especially 5 years posttransplant (56%, 60%, and 62%, respectively).

Conclusions: Low depression in conjunction with social integration at time of waitlisting is related to enhanced chances for survival after HTx. Both factors should be considered for inclusion in standardized assessments and interventions for HTx candidates. We evaluated depression and social isolation assessed at time of waitlisting as predictors of survival in heart transplant (HTx) recipients.\r\n\r\nMethods and Results: Between 2005 and 2006, 318 adult HTx candidates were enrolled in the Waiting for a New Heart Study, and 164 received transplantation. Patients were followed until February 2013. Psychosocial characteristics were assessed by questionnaires. Eurotransplant provided medical data at waitlisting, transplantation dates, and donor characteristics; hospitals reported medical data at HTx and date of death after HTx. During a median follow‐up of 70 months (<1–93 months post‐HTx), 56 (38%) of 148 transplanted patients with complete data died. Depression scores were unrelated to social isolation, and neither correlated with disease severity. Higher depression scores increased the risk of dying (hazard ratio=1.07, 95% confidence interval, 1.01, 1.15, P=0.032), which was moderated by social isolation scores (significant interaction term; hazard ratio = 0.985, 95% confidence interval, 0.973, 0.998; P=0.022). These findings were maintained in multivariate models controlling for covariates (P values 0.020–0.039). Actuarial 1‐year/5‐year survival was best for patients with low depression who were not socially isolated at waitlisting (86% after 1 year, 79% after 5 years). Survival of those who were either depressed, or socially isolated or both, was lower, especially 5 years posttransplant (56%, 60%, and 62%, respectively).

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