Depressive symptoms and mortality in lung transplant.
OBJECTIVE
To determine whether depressive symptoms predicted survival before and after lung transplantation. We hypothesized that depressive symptoms might predict survival of wait-listed patients, but would not predict survival post-transplant.


METHODS
This was a prospective, longitudinal study. Participants completed the Beck Depression Inventory pre-transplant. Pre-transplant survival analyses were conducted (n = 124) based on time from list date, to death, transplant, or censoring, if still alive. Post-transplant survival analyses were conducted (n = 76) based on time from transplant, to death or censoring. Cox proportional hazards regression analyses were utilized.


RESULTS
In the unadjusted model, depressive symptoms predicted mortality for candidates awaiting lung transplant (p = 0.02); however, once models were adjusted for demographics and pulmonary status, the relationship between depressive symptoms and mortality rates was attenuated (p > 0.05). Depressive symptoms did not predict survival after lung transplant (p > 0.05).


CONCLUSIONS
Pre-transplant depressive symptoms were associated with mortality among lung transplant candidates in an unadjusted model and a model fit with demographics and forced expiratory volume in one second. Depressive symptoms do not exert an independent effect when forced expiratory vital capacity is added. Depressive symptoms do not predict mortality after transplant. Future studies need to determine whether pre-transplant psychosocial characteristics confer a greater risk for poorer transplant outcomes.
Evon
Donna M
DM
Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7205, USA.
Burker
Eileen J
EJ
Galanko
Joseph A
JA
Dedert
Eric
E
Egan
Thomas M
TM
D000328:Adult; D003863:Depression / Q000401:mortality* / Q000523:psychology*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D017093:Liver Failure / Q000601:surgery*; D008137:Longitudinal Studies; D016040:Lung Transplantation / Q000401:mortality* / Q000523:psychology*; D008297:Male; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome