Bui Yvonne Tran, Hathcock Matthew A, Benzo Roberto P, Budev Marie M, Chandrashekaran Satish, Erasmus David B, Lease Erika D, Levine Deborah J, Thompson Karin L, Johnson Bradley K, Jowsey-Gregoire Sheila G, Kennedy Cassie C
Mayo Clinic Alix School of Medicine, Rochester, Minnesota, USA.
Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA.
Clin Transplant. 2020 Oct;34(10):e14056. doi: 10.1111/ctr.14056. Epub 2020 Sep 23.
Resilience represents the capacity to adapt to adversity. Resilience can improve following behavioral interventions. We examined lung transplant candidates' resilience as a novel predictor using the Connor-Davidson Resilience Scale (RISC-10).
Waitlisted candidates at six centers were mailed questionnaires from 9/16/2015 to 10/1/2019. Follow-up surveys were collected annually and post-transplant. Outcomes were recorded through February 17, 2020. Primary outcome was pre-transplant death/delisting. Analyses included t test or chi-square for group comparisons, Pearson's correlation coefficients for strength of relationships, and Cox proportional-hazard models to evaluate associations with outcomes, adjusting for age, sex, and mood.
Participation was 55.3% (N = 199). Baseline RISC-10 averaged 32.0 ± 5.6 and did not differ by demographics, primary transplant diagnosis, or disease severity markers. RISC-10 did not correlate to the commonly utilized Psychosocial Assessment of Candidates for Transplant [PACT] or Stanford Integrated Psychosocial Assessment for Transplantation [SIPAT] tools. Scores < 26.3 (representing > 1 standard deviation below population average) occurred in 16% and were associated with pre-transplant death or delisting, adjusted Hazard Ratio of 2.60 (95% Confidence Interval 1.23-5.77; P = .01).
One in six lung candidates had low resilience, predicting increased pre-transplant death/delisting. RISC-10 did not correlate with PACT or SIPAT; resilience may represent a novel risk factor.
心理韧性代表了适应逆境的能力。行为干预后心理韧性可得到改善。我们使用康纳-戴维森心理韧性量表（RISC-10），将肺移植候选者的心理韧性作为一种新的预测指标进行了研究。
2015年9月16日至2019年10月1日，向六个中心等待名单上的候选者邮寄了问卷。每年及移植后均收集随访调查。结局记录至2020年2月17日。主要结局为移植前死亡/退出等待名单。分析包括用于组间比较的t检验或卡方检验、用于关系强度的Pearson相关系数，以及用于评估与结局的关联并对年龄、性别和情绪进行调整的Cox比例风险模型。
参与率为55.3%（N = 199）。基线RISC-10平均为32.0±5.6，在人口统计学特征、主要移植诊断或疾病严重程度标志物方面无差异。RISC-10与常用的移植候选者心理社会评估[PACT]或斯坦福移植综合心理社会评估[SIPAT]工具无关。得分<26.3（代表低于总体平均水平超过1个标准差）的情况占16%，并与移植前死亡或退出等待名单相关，调整后的风险比为2.60（95%置信区间1.23 - 5.77；P = 0.01）。
六分之一的肺移植候选者心理韧性较低，预示着移植前死亡/退出等待名单的风险增加。RISC-10与PACT或SIPAT无关；心理韧性可能是一个新的风险因素。
