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Is Functional Independence Associated With Improved Long-Term Survival After Lung Transplantation?

Publication ,  Journal Article
Osho, A; Mulvihill, M; Lamba, N; Hirji, S; Yerokun, B; Bishawi, M; Spencer, P; Panda, N; Villavicencio, M; Hartwig, M
Published in: Ann Thorac Surg
July 2018

BACKGROUND: Existing research demonstrates superior short-term outcomes (length of stay, 1-year survival) after lung transplantation in patients with preoperative functional independence. The aim of this study was to determine whether advantages remain significant in the long-term. METHODS: The United Network for Organ Sharing database was queried for adult, first-time, isolated lung transplantation records from January 2005 to December 2015. Stratification was performed based on Karnofsky Performance Status Score (3 groups) and on employment at the time of transplantation (2 groups). Kaplan-Meier and Cox analyses were performed to determine the association between these factors and survival in the long-term. RESULTS: Of 16,497 patients meeting criteria, 1,581 (9.6%) were almost completely independent at the time of transplant vs 5,662 (34.3%) who were disabled (completely reliant on others for activities of daily living). Cox models adjusting for recipient, donor, and transplant factors demonstrated a statistically significant association between disability at the time of transplant and long-term death (hazard ratio, 1.26; 95% confidence interval, 1.14 to 1.40; p < 0.001). There were 15,931 patients with available data on paid employment at the time of transplantation. Multivariable analysis demonstrated a statistically significant association between employment at the time of transplantation and death (hazard ratio, 0.86; 95% confidence interval, 0.75 to 0.91; p < 0.001). CONCLUSIONS: Preoperative functional independence and maintenance of employment are associated with superior long-term outcomes in lung recipients. The results highlight potential benefits of pretransplant functional rehabilitation for patients on the waiting list for lungs.

Duke Scholars

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

July 2018

Volume

106

Issue

1

Start / End Page

79 / 84

Location

Netherlands

Related Subject Headings

  • Waiting Lists
  • Treatment Outcome
  • Tissue and Organ Procurement
  • Time Factors
  • Survival Analysis
  • Risk Assessment
  • Retrospective Studies
  • Respiratory System
  • Proportional Hazards Models
  • Preoperative Period
 

Citation

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Osho, A., Mulvihill, M., Lamba, N., Hirji, S., Yerokun, B., Bishawi, M., … Hartwig, M. (2018). Is Functional Independence Associated With Improved Long-Term Survival After Lung Transplantation? Ann Thorac Surg, 106(1), 79–84. https://doi.org/10.1016/j.athoracsur.2018.01.069
Osho, Asishana, Michael Mulvihill, Nayan Lamba, Sameer Hirji, Babatunde Yerokun, Muath Bishawi, Philip Spencer, Nikhil Panda, Mauricio Villavicencio, and Matthew Hartwig. “Is Functional Independence Associated With Improved Long-Term Survival After Lung Transplantation?Ann Thorac Surg 106, no. 1 (July 2018): 79–84. https://doi.org/10.1016/j.athoracsur.2018.01.069.
Osho A, Mulvihill M, Lamba N, Hirji S, Yerokun B, Bishawi M, et al. Is Functional Independence Associated With Improved Long-Term Survival After Lung Transplantation? Ann Thorac Surg. 2018 Jul;106(1):79–84.
Osho, Asishana, et al. “Is Functional Independence Associated With Improved Long-Term Survival After Lung Transplantation?Ann Thorac Surg, vol. 106, no. 1, July 2018, pp. 79–84. Pubmed, doi:10.1016/j.athoracsur.2018.01.069.
Osho A, Mulvihill M, Lamba N, Hirji S, Yerokun B, Bishawi M, Spencer P, Panda N, Villavicencio M, Hartwig M. Is Functional Independence Associated With Improved Long-Term Survival After Lung Transplantation? Ann Thorac Surg. 2018 Jul;106(1):79–84.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

July 2018

Volume

106

Issue

1

Start / End Page

79 / 84

Location

Netherlands

Related Subject Headings

  • Waiting Lists
  • Treatment Outcome
  • Tissue and Organ Procurement
  • Time Factors
  • Survival Analysis
  • Risk Assessment
  • Retrospective Studies
  • Respiratory System
  • Proportional Hazards Models
  • Preoperative Period