Tags

Type your tag names separated by a space and hit enter

Social isolation and depression predict 12-month outcomes in the "waiting for a new heart study".

Abstract

BACKGROUND

Identification of modifiable psychosocial characteristics related to survival of heart transplant (HTx) candidates is needed to prevent clinical deterioration and improve prognosis.

METHODS

A multi-site, prospective study was conducted with 318 HTx candidates (18% female, 82% male; 53 +/- 11 years of age) newly listed at 17 hospitals in Germany and Austria. Baseline demographic and psychosocial characteristics were assessed by questionnaires. Indicators of disease severity (Heart Failure Survival Score, creatinine, cardiac index) and 12-month outcomes (death, high-urgency HTx, elective HTx, de-listing due to deterioration or improvement) were provided by Eurotransplant.

RESULTS

By 12 months, 33 patients died, 83 received an urgent HTx, 30 underwent an elective HTx, and 9 were de-listed due to clinical deterioration and 17 due to improvement. All measures of disease severity predicted outcomes. Controlling for disease severity, the number of social contacts contributed significantly to outcomes, favoring those who improved. Comparing socially isolated patients (<4 social contacts/month) who also had depression scores in the clinical range (high psychosocial risk group; n = 37) to those with >10 social contacts/month without depression (low psychosocial risk group; n = 47) revealed significant differences in the distribution of outcome frequencies (chi-square = 11.2, df = 4, p < 0.04). The high psychosocial risk group was more likely to have died/deteriorated and less likely to have improved than the low psychosocial risk group.

CONCLUSIONS

Regardless of disease severity, socially isolated HTx candidates who are also depressed may be at increased risk for clinical deterioration and mortality, indicating a need for psychosocial intervention.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Psychological Institute, Johannes Gutenberg University, Mainz, Germany. spaderna@uni-mainz.de

    , , , , ,

    Source

    MeSH

    Adult
    Aged
    Austria
    Depression
    Female
    Germany
    Heart Diseases
    Heart Transplantation
    Humans
    Male
    Middle Aged
    Outcome Assessment (Health Care)
    Prognosis
    Prospective Studies
    Psychology
    Risk Factors
    Severity of Illness Index
    Social Isolation
    Waiting Lists

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19804987

    Citation

    Spaderna, Heike, et al. "Social Isolation and Depression Predict 12-month Outcomes in the "waiting for a New Heart Study"." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 29, no. 3, 2010, pp. 247-54.
    Spaderna H, Mendell NR, Zahn D, et al. Social isolation and depression predict 12-month outcomes in the "waiting for a new heart study". J Heart Lung Transplant. 2010;29(3):247-54.
    Spaderna, H., Mendell, N. R., Zahn, D., Wang, Y., Kahn, J., Smits, J. M., & Weidner, G. (2010). Social isolation and depression predict 12-month outcomes in the "waiting for a new heart study". The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 29(3), pp. 247-54. doi:10.1016/j.healun.2009.07.018.
    Spaderna H, et al. Social Isolation and Depression Predict 12-month Outcomes in the "waiting for a New Heart Study". J Heart Lung Transplant. 2010;29(3):247-54. PubMed PMID: 19804987.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Social isolation and depression predict 12-month outcomes in the "waiting for a new heart study". AU - Spaderna,Heike, AU - Mendell,Nancy Role, AU - Zahn,Daniela, AU - Wang,Yifan, AU - Kahn,Judith, AU - Smits,Jacqueline M A, AU - Weidner,Gerdi, Y1 - 2009/10/04/ PY - 2009/04/28/received PY - 2009/07/28/revised PY - 2009/07/29/accepted PY - 2009/10/7/entrez PY - 2009/10/7/pubmed PY - 2010/7/7/medline SP - 247 EP - 54 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J. Heart Lung Transplant. VL - 29 IS - 3 N2 - BACKGROUND: Identification of modifiable psychosocial characteristics related to survival of heart transplant (HTx) candidates is needed to prevent clinical deterioration and improve prognosis. METHODS: A multi-site, prospective study was conducted with 318 HTx candidates (18% female, 82% male; 53 +/- 11 years of age) newly listed at 17 hospitals in Germany and Austria. Baseline demographic and psychosocial characteristics were assessed by questionnaires. Indicators of disease severity (Heart Failure Survival Score, creatinine, cardiac index) and 12-month outcomes (death, high-urgency HTx, elective HTx, de-listing due to deterioration or improvement) were provided by Eurotransplant. RESULTS: By 12 months, 33 patients died, 83 received an urgent HTx, 30 underwent an elective HTx, and 9 were de-listed due to clinical deterioration and 17 due to improvement. All measures of disease severity predicted outcomes. Controlling for disease severity, the number of social contacts contributed significantly to outcomes, favoring those who improved. Comparing socially isolated patients (<4 social contacts/month) who also had depression scores in the clinical range (high psychosocial risk group; n = 37) to those with >10 social contacts/month without depression (low psychosocial risk group; n = 47) revealed significant differences in the distribution of outcome frequencies (chi-square = 11.2, df = 4, p < 0.04). The high psychosocial risk group was more likely to have died/deteriorated and less likely to have improved than the low psychosocial risk group. CONCLUSIONS: Regardless of disease severity, socially isolated HTx candidates who are also depressed may be at increased risk for clinical deterioration and mortality, indicating a need for psychosocial intervention. SN - 1557-3117 UR - https://www.unboundmedicine.com/medline/citation/19804987/Social_isolation_and_depression_predict_12_month_outcomes_in_the_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053-2498(09)00614-7 DB - PRIME DP - Unbound Medicine ER -