Impact of psychiatric comorbidities on outcomes of elderly liver transplant recipients

Shehzad K. Niazi, Terry D. Schneekloth, Adriana R. Vasquez, Andrew P. Keaveny, Susan Davis, Melissa Picco, Michael G. Heckman, Nancy N. Diehl, Sheila G. Jowsey-Gregoire, Teresa A. Rummans, C. Burcin Taner

Research output: Contribution to journalArticle

Abstract

Objectives: This study evaluated the impact of psychiatric comorbidities in liver transplant (LT) recipients aged ≥65 years (elderly) on length of hospital-stay (LOS), death, and a composite outcome of graft loss or death. Methods: This retrospective study assessed impact of psychiatric comorbidities in 122 elderly LT recipients and a matched group of 122 LT recipients aged <65 years (younger). Associations were assessed using adjusted multivariable regression models. Results: Among elderly, median age at LT was 68 years, most were males (62%), white (85%) and 61.7% had a history of any psychiatric diagnosis. Among younger, median age was 55, most were males (67.2%), white (77.5%) and 61.5% had any psychiatric diagnosis. Median LOS was 8 days for both groups. Among elderly, after a median follow-up of 5 years, 25.4% died and 29.5% experienced graft loss or death. History of adjustment disorder, history of depression, past psychiatric medication use, and pain prior to LT were associated with an increased risk of death or the composite graft loss or death. Perioperative use of SSRIs and lack of sleeping medication use were associated with longer LOS. Among aged <65, after median follow-up of 4.7 years, 21 patients (17%) died and 25 (20%) experienced graft loss or death; history of depression, perioperative SSRIs or sleeping medications use was associated with increased mortality and graft-loss or death. Conclusion: Six out of 10 patients among both elderly and younger cohorts had pre-LT psychiatric comorbidities, some of which adversely affected outcomes after LT.

Original languageEnglish (US)
Pages (from-to)27-35
Number of pages9
JournalJournal of Psychosomatic Research
Volume111
DOIs
StatePublished - Aug 1 2018

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Keywords

  • Anxiety and survival after liver transplant
  • Anxiety in liver transplantation
  • Elderly liver transplant recipients
  • Length of stay after liver transplant
  • Post liver transplant mortality

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Niazi, S. K., Schneekloth, T. D., Vasquez, A. R., Keaveny, A. P., Davis, S., Picco, M., Heckman, M. G., Diehl, N. N., Jowsey-Gregoire, S. G., Rummans, T. A., & Burcin Taner, C. (2018). Impact of psychiatric comorbidities on outcomes of elderly liver transplant recipients. Journal of Psychosomatic Research, 111, 27-35. https://doi.org/10.1016/j.jpsychores.2018.05.005