Depressive Symptoms in Lung Transplant Recipients: Trajectory and Association with Mortality and Allograft Dysfunction

Details

• Personal Author:
  Blanc PD ; Gao Y ; Golden JA ; Greenland JR ; Hays SR ; Katz PP ; Kleinhenz ME ; Kolaitis NA ; Kukreja J ; Leard LE ; Shah RJ ; Singer JP ; Smith PJ ; Soong A ; Venado A
• Description:
  Objective: Most studies observing an association between depressive symptoms following lung transplantation and mortality are limited to depressive symptom measurement at a single time point, unrelated to allograft function. We aimed to test the association of depressive symptoms over multiple assessments with allograft dysfunction and with mortality. Methods: We assessed depressive symptoms before and serially up to 3 years after lung transplantation in lung transplant recipients. We quantified depressive symptoms with the Geriatric Depression Scale (GDS; range 0-15; minimally important difference (MID): 2). We quantified changes in GDS using linear mixed effects models and tested the association with mortality using Cox proportional hazards models with GDS as a time-dependent predictor. To determine if worsening in GDS preceded declines in lung function, we tested the association of GDS as a time-dependent predictor with the lagged outcome of FEV1 at the following study visit. Results: Among 266 participants, depressive symptoms improved early after transplantation. Worsening in post-transplant GDS by the MID was associated with mortality (HR 1.25, 95% CI 1.05 to 1.50), and in lagged outcome analyses with decreased per cent predicted FEV1 (delta, -1.62%, 95% CI -2.49 to -0.76). Visual analyses of temporal changes in GDS demonstrated that worsening depressive symptoms could precede chronic lung allograft dysfunction. Conclusions: Depressive symptoms generally improve after lung transplantation. When they worsen, however, there is an association with declines in lung function and mortality. Depression is one of the few, potentially modifiable, risk factors for chronic lung allograft dysfunction and death. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Delivery Of Health Care Lung Mental Health Mortality Nervous System Occupational Health Respiratory System Safety
• Keywords:
  Cohort Studies Longitudinal Study Lung Function Medical Care Mental Health Mortality Data Quality Of Life
• ISSN:
  0040-6376
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; North Carolina ; OSHA Region 4 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  77
• Issue:
  9
• NIOSHTIC Number:
  nn:20067252
• Citation:
  Thorax 2022 Sep; 77(9):891-899
• Contact Point Address:
  Dr Nicholas A Kolaitis, Department of Medicine, University of California San Francisco, San Francisco, California, USA
• Email:
  Nicholas.kolaitis@ucsf.edu
• Federal Fiscal Year:
  2022
• Performing Organization:
  University of California, Berkeley
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Thorax
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:6999b19699dd478dc1545902f92337c691da3ac682ebcaf6520cb627d940b0201a326e77167dc850b8d02540046d64679409f84da1e77ff4f373d5b981500ccd
• Download URL:
  https://stacks.cdc.gov/view/cdc/231367/cdc_231367_DS1.pdf
• File Type:
  [PDF - 1.06 MB ]