Patient-reported dyspnea and health predict waitlist mortality in patients waiting for lung transplantation in Japan

Masaki Ikeda, Toru Oga, Toyofumi F. Chen-Yoshikawa, Junko Tokuno, Takahiro Oto, Tomoyo Okawa, Yoshinori Okada, Miki Akiba, Satona Tanaka, Yoshito Yamada, Yojiro Yutaka, Akihiro Ohsumi, Daisuke Nakajima, Masatsugu Hamaji, Maki Isomi, Kazuo Chin, Hiroshi Date

研究成果: Article査読

抄録

Background: Waitlist mortality due to donor shortage for lung transplantation is a serious problem worldwide. Currently, the selection of recipients in Japan is mainly based on the registration order. Hence, scientific evidence for risk stratification regarding waitlist mortality is urgently needed. We hypothesized that patient-reported dyspnea and health would predict mortality in patients waitlisted for lung transplantation. Methods: We analyzed factors related to waitlist mortality using data of 203 patients who were registered as candidates for lung transplantation from deceased donors. Dyspnea was evaluated using the modified Medical Research Council (mMRC) dyspnea scale, and the health status was determined with St. George’s Respiratory Questionnaire (SGRQ). Results: Among 197 patients who met the inclusion criteria, the main underlying disease was interstitial lung disease (99 patients). During the median follow-up period of 572 days, 72 patients died and 96 received lung transplantation (69 from deceased donors). Univariable competing risk analyses revealed that both mMRC dyspnea and SGRQ Total score were significantly associated with waitlist mortality (p = 0.003 and p < 0.001, respectively) as well as age, interstitial lung disease, arterial partial pressure of carbon dioxide, and forced vital capacity. Multivariable competing risk analyses revealed that the mMRC and SGRQ score were associated with waitlist mortality in addition to age and interstitial lung disease. Conclusions: Both mMRC dyspnea and SGRQ score were significantly associated with waitlist mortality, in addition to other clinical variables such as patients’ background, underlying disease, and pulmonary function. Patient-reported dyspnea and health may be measured through multi-dimensional analysis (including subjective perceptions) and for risk stratification regarding waitlist mortality.

本文言語English
論文番号116
ジャーナルRespiratory Research
22
1
DOI
出版ステータスPublished - 2021 12

ASJC Scopus subject areas

  • 呼吸器内科

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