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The impact of depression on heart transplant outcomes: A retrospective single‐center cohort study
Author(s) -
Rosa Angelo,
SingerEnglar Tahli,
Hamilton Michele A.,
IsHak Waguih William,
Kobashigawa Jon A.,
Kittleson Michelle M.
Publication year - 2021
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14204
Subject(s) - medicine , depression (economics) , intensive care unit , heart transplantation , retrospective cohort study , single center , transplantation , cohort , intensive care medicine , emergency medicine , economics , macroeconomics
Background Depression is prevalent in patients with heart failure and after heart transplant. We identified the prevalence of pre‐ and post‐transplant depression and its association with clinical characteristics and post‐transplant outcomes. Methods We reviewed 114 adults transplanted 1/1/2015 to 12/31/2015 and identified patients with pre‐ and post‐transplant depression. Clinical characteristics and outcomes were compared. Results Of 114 patients, 35.1% had pre‐transplant depression and 26.3% had post‐transplant depression. Patients with post‐transplant depression within the first year were significantly more likely to have acute rejection (10% vs 0%), longer intensive care unit (11.7 days vs 7.8 days) and hospital stay (31.7 days vs 16.3 days), and discharge to inpatient rehabilitation (26.7% vs 8.3%). Patients with post‐transplant depression within the first year had significantly higher 5‐year mortality (30% vs 9.5%, p = .009). However, after adjustment for total artificial heart/biventricular assist device, acute rejection, intensive care unit, and hospital length of stay, this relationship was no longer significant (HR 2.11; 95% CI 0.18‐25.27; p = .556). Conclusions Depression is common among heart transplant candidates and recipients. While pre‐transplant depression did not impact outcomes, patients with post‐transplant depression were more likely to have had a complicated course, suggesting the need for increased vigilance regarding depression in such patients.