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Postoperative cognitive dysfunction and mortality following lung transplantation.

Publication ,  Journal Article
Smith, PJ; Blumenthal, JA; Hoffman, BM; Davis, RD; Palmer, SM
Published in: Am J Transplant
March 2018

Preliminary evidence suggests that postoperative cognitive dysfunction (POCD) is common after lung transplantation. The impact of POCD on clinical outcomes has yet to be studied. The association between POCD and longer-term survival was therefore examined in a pilot study of posttransplantation survivors. Forty-nine participants from a prior randomized clinical trial underwent a neurocognitive assessment battery pretransplantation and 6 months posttransplantation, including assessments of the domains of Executive Function (Trail Making Test, Stroop, Digit Span), Processing Speed (Ruff 2 and 7 Test, Digit Symbol Substitution Test), and Verbal Memory (Verbal Paired Associates, Logical Memory, Animal Naming, and Controlled Oral Word Association Test). During a 13-year follow-up, 33 (67%) participants died. Greater neurocognition was associated with longer survival (hazard ratio [HR] = 0.49 [0.25-0.96], P = .039), and this association was strongest on tests assessing Processing Speed (HR = 0.58 [0.36-0.95], P = .03) and Executive Function (HR = 0.52 [0.28-0.97], P = .040). In addition, unadjusted analyses suggested an association between greater Memory performance and lower risk of CLAD (HR = 0.54 [0.29-1.00], P = .050). Declines in Executive Function tended to be predictive of worse survival. These preliminary findings suggest that postoperative neurocognition is predictive of subsequent mortality among lung transplant recipients. Further research is needed to confirm these findings in a larger sample and to examine mechanisms responsible for this relationship.

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Published In

Am J Transplant

DOI

EISSN

1600-6143

Publication Date

March 2018

Volume

18

Issue

3

Start / End Page

696 / 703

Location

United States

Related Subject Headings

  • Survival Rate
  • Surgery
  • Risk Factors
  • Quality of Life
  • Prognosis
  • Postoperative Complications
  • Pilot Projects
  • Neuropsychological Tests
  • Middle Aged
  • Male
 

Citation

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Smith, P. J., Blumenthal, J. A., Hoffman, B. M., Davis, R. D., & Palmer, S. M. (2018). Postoperative cognitive dysfunction and mortality following lung transplantation. Am J Transplant, 18(3), 696–703. https://doi.org/10.1111/ajt.14570
Smith, P. J., J. A. Blumenthal, B. M. Hoffman, R. D. Davis, and S. M. Palmer. “Postoperative cognitive dysfunction and mortality following lung transplantation.Am J Transplant 18, no. 3 (March 2018): 696–703. https://doi.org/10.1111/ajt.14570.
Smith PJ, Blumenthal JA, Hoffman BM, Davis RD, Palmer SM. Postoperative cognitive dysfunction and mortality following lung transplantation. Am J Transplant. 2018 Mar;18(3):696–703.
Smith, P. J., et al. “Postoperative cognitive dysfunction and mortality following lung transplantation.Am J Transplant, vol. 18, no. 3, Mar. 2018, pp. 696–703. Pubmed, doi:10.1111/ajt.14570.
Smith PJ, Blumenthal JA, Hoffman BM, Davis RD, Palmer SM. Postoperative cognitive dysfunction and mortality following lung transplantation. Am J Transplant. 2018 Mar;18(3):696–703.
Journal cover image

Published In

Am J Transplant

DOI

EISSN

1600-6143

Publication Date

March 2018

Volume

18

Issue

3

Start / End Page

696 / 703

Location

United States

Related Subject Headings

  • Survival Rate
  • Surgery
  • Risk Factors
  • Quality of Life
  • Prognosis
  • Postoperative Complications
  • Pilot Projects
  • Neuropsychological Tests
  • Middle Aged
  • Male