General hospital psychiatry · 2026
Psychological distress and cause-specific readmissions during early recovery after lung transplantation: A prospective cohort study.
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Mou Xiaoling, Huang Jiajia, Qin Jinfeng, Huang Danxia, Chen Mengyao, He Siqi, He Jianxing, Xu Xin, Ju Chunrong, Chen Ying, Shen Wei
Аннотация
BACKGROUND: Early recovery after lung transplantation involves psychological distress, symptom burden, functional limitations, and recurrent readmissions. We examined whether anxiety and depressive symptom severity were differentially associated with graft-related and surgery-related recurrent readmissions during the first 6 months after transplantation.
METHODS: In this prospective single-center cohort, 74 adult lung transplant recipients completed assessments at 1, 3, and 6 months. Anxiety, depressive symptoms, health-related quality of life, and transplant-related symptoms were assessed using validated instruments. Readmissions were adjudicated by principal discharge diagnosis and analyzed as recurrent events using mean cumulative function curves and multivariable Poisson regression with follow-up time as an offset.
RESULTS: At 6 months, mean cumulative readmission burden was 0.39 events per patient for graft-related readmissions and 0.26 for surgery-related readmissions. Anxiety severity grade was associated with graft-related readmission (incidence rate ratio [IRR], 1.63; 95% confidence interval [CI], 1.08-2.48), whereas depressive symptom severity was associated with surgery-related readmission (IRR, 2.81; 95% CI, 1.20-6.59). Physical Functioning improved from 22.5 to 72.5, whereas psychological recovery and symptom resolution were more gradual.
CONCLUSIONS: During the first 6 months after lung transplantation, anxiety and depressive symptom severity were associated with different cause-specific recurrent readmission profiles. These interval-level associations indicate clinically relevant recovery vulnerability rather than temporal causation. Brief GAD-7 and PHQ-9 screening may add context to symptom assessment and clinical surveillance during early follow-up.
METHODS: In this prospective single-center cohort, 74 adult lung transplant recipients completed assessments at 1, 3, and 6 months. Anxiety, depressive symptoms, health-related quality of life, and transplant-related symptoms were assessed using validated instruments. Readmissions were adjudicated by principal discharge diagnosis and analyzed as recurrent events using mean cumulative function curves and multivariable Poisson regression with follow-up time as an offset.
RESULTS: At 6 months, mean cumulative readmission burden was 0.39 events per patient for graft-related readmissions and 0.26 for surgery-related readmissions. Anxiety severity grade was associated with graft-related readmission (incidence rate ratio [IRR], 1.63; 95% confidence interval [CI], 1.08-2.48), whereas depressive symptom severity was associated with surgery-related readmission (IRR, 2.81; 95% CI, 1.20-6.59). Physical Functioning improved from 22.5 to 72.5, whereas psychological recovery and symptom resolution were more gradual.
CONCLUSIONS: During the first 6 months after lung transplantation, anxiety and depressive symptom severity were associated with different cause-specific recurrent readmission profiles. These interval-level associations indicate clinically relevant recovery vulnerability rather than temporal causation. Brief GAD-7 and PHQ-9 screening may add context to symptom assessment and clinical surveillance during early follow-up.