Are Psychopharmacological Treatments Risk Factors for Mortality in Lung Transplant Recipients? - Retrospective Study

Abstract

Purpose Despite clinical advance, long-term survival after lung transplantation (LT) remains poor. Thus, the recognition of risk factors associated with poorer survival is a key goal of LT research. Few studies have examined the psychiatric risk factors for mortality in LT recipients. The aim of this research was to study psychopharmacological treatment during lung transplant hospitalization (LTH) as predictor of mortality. Methods We conducted a retrospective cohort analysis of clinical records of lung transplant recipients, transplanted at Favaloro Foundation University Hospital between 2007 and 2019 (n = 238). Psychopharmacological treatment was measured as the number of days of treatment during LTH with: antidepressants (AD), antipsychotics (AP), hypnotics (HYP), and benzodiazepines (BZD). In addition, the number of psychology and psychiatry consultations during LTH and the prescription of psychotropic drugs at medical discharge were measured. Mortality was measured as survival at two years from LT. A multiple logistic regression model was used for data analysis. Results 12.2% of patients were treated with hypnotics. Greater number of days of treatment with HYP in LTH is associated with a higher mortality at two years after LT (β = -0.49; 95% CI, -0.92, -0.06; p=.02). Prescription of psychotropic drugs at medical discharge is associated with an increase survival at two years after LT (β = 0.36; 95% CI, 0.05, 0.66; p=.02). However, the number of days of treatment with AD, AP, BZD, and the number of psychology and psychiatry consultations during the LTH didn´t report significant results. Conclusion In this study, prescription of psychotropic drugs at medical discharge was significantly associated with increased survival; showing a significant association between HYP treatment in LTH and mortality. Future research is needed to study more specifically post-LT psychiatric interventions.