Neurocognitive status is associated with all-cause mortality among psychiatric, high-risk liver transplant candidates and recipients

Alok Madan, J. J. Borckardt, W. E. Balliet, K. S. Barth, L. M. Delustro, R. M. Malcolm, D. Koch, I. Willner, P. Baliga, A. Reuben

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective: Judicious selection of potential liver transplant candidates and close monitoring of progress are essential to successful outcomes. Pretransplant psychosocial evaluations are the norm, but the relationship between psychosocial (and neurocognitive status) and longer term medical outcomes is understudied. This exploratory study sought to examine the relationship between objective measures of pretransplant psychosocial and neurocognitive status and service utilization, transplant status, and all-cause mortality. Methods: This retrospective chart review examined outcomes among 108 psychiatric, high-risk liver transplant candidates up to four years following initial evaluation. Predictor variables of outcomes included demographic, medical, neurocognitive, psychological, and mental health treatment variables. Results: Transplant status and neurocognitive functioning were independently associated with all-cause mortality. None of the other variables were associated with outcomes. Conclusions: Better neurocognitive functioning in high-risk liver transplant candidates may allow for greater involvement in medical care and/or compliance with treatment recommendations. More aggressive assessment and management of neurocognitive dysfunction may improve outcomes. Objective measures identified significant psychopathology typical of liver transplant candidates but were not associated with outcomes; engagement in specialized mental health care may have attenuated this relationship. Further study is needed to better understand the relationship between psychosocial functioning and outcomes.

Original languageEnglish (US)
Pages (from-to)279-295
Number of pages17
JournalInternational Journal of Psychiatry in Medicine
Volume49
Issue number4
DOIs
StatePublished - May 1 2015

Keywords

  • Executive function
  • Liver transplantation
  • Memory
  • Mortality
  • Outcomes research
  • Psychosocial factors

ASJC Scopus subject areas

  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Neurocognitive status is associated with all-cause mortality among psychiatric, high-risk liver transplant candidates and recipients'. Together they form a unique fingerprint.

Cite this