Institute of Clinical Physiology, National Research Council, Pisa, Italy.
Liver Transpl. 2010 Oct;16(10):1158-63. doi: 10.1002/lt.22122.
We tested the hypothesis that religiosity (ie, seeking God's help, having faith in God, trusting in God, and trying to perceive God's will in the disease) is associated with improved survival in patients with end-stage liver disease who have undergone orthotopic liver transplantation. We studied a group of 179 candidates for liver transplantation who responded to a questionnaire on religiosity during the pretransplant psychological evaluation and underwent transplantation between 2004 and 2007. The demographic data, educational level, employment status, clinical data, and results of the questionnaire were compared with the survival of patients during follow-up, regardless of the cause of any deaths. Factorial analysis of responses to the questionnaire revealed 3 main factors: searching for God (active), waiting for God (passive), and fatalism. The consistency of the matrix was very high (consistency index = 0.92). Eighteen patients died during follow-up (median time = 21 months). In multivariate analysis, only the searching for God factor [hazard ratio (HR) = 2.95, 95% confidence interval (CI) = 1.05-8.32, χ(2) = 4.205, P = 0.040] and the posttransplant length of stay in the intensive care unit (HR = 1.05, 95% CI = 1.01-1.08, χ(2) = 8.506, P = 0.035) were independently associated with survival, even after adjustments for the waiting for God factor, fatalism, age, sex, marital status, employment, educational level, viral etiology, Child-Pugh score, serum creatinine level, time from the questionnaire to transplantation, donor age, and intraoperative bleeding. Patients who did not present the searching for God factor were younger than those who did, but they had shorter survival times (P = 0.037) and a 3-fold increased relative risk of dying (HR = 3.01, 95% CI = 1.07-8.45). In conclusion, religiosity is associated with prolonged survival in patients undergoing liver transplantation.
我们验证了这样一个假设，即在经历了原位肝移植的终末期肝病患者中，宗教信仰（即寻求上帝的帮助、对上帝的信仰、对上帝的信任以及试图感知疾病中的上帝旨意）与改善生存率有关。我们研究了一组 179 名接受肝移植的候选人，他们在移植前的心理评估中对宗教信仰进行了问卷调查，并在 2004 年至 2007 年间接受了移植。比较了人口统计学数据、教育水平、就业状况、临床数据和问卷调查结果与患者随访期间的生存率，无论任何原因导致的死亡。对问卷回答的因子分析揭示了 3 个主要因素：寻找上帝（积极）、等待上帝（消极）和宿命论。矩阵的一致性非常高（一致性指数=0.92）。18 名患者在随访期间死亡（中位数时间=21 个月）。在多变量分析中，只有寻找上帝因素[风险比（HR）=2.95，95%置信区间（CI）=1.05-8.32，χ²（2）=4.205，P=0.040]和移植后重症监护病房住院时间（HR=1.05，95%CI=1.01-1.08，χ²（2）=8.506，P=0.035）与生存率独立相关，即使在调整了等待上帝因素、宿命论、年龄、性别、婚姻状况、就业、教育水平、病毒病因、Child-Pugh 评分、血清肌酐水平、从问卷到移植的时间、供体年龄和术中出血后也是如此。未表现出寻找上帝因素的患者比表现出该因素的患者年轻，但他们的生存时间更短（P=0.037），死亡的相对风险增加了 3 倍（HR=3.01，95%CI=1.07-8.45）。总之，宗教信仰与接受肝移植的患者的生存率延长有关。
