Patient-reported health outcomes in long-term lung transplantation survivors: A prospective cohort study

Abstract

During the last three decades lung transplantation (LTx) has become a proven modality for increasing both survival and health-related quality of life (HRQoL) in patients with various end-stage lung diseases. Most previous studies have reported improved HRQoL shortly after LTx. With regard to long-term effects on HRQoL, however, the evidence is less solid. This prospective cohort study was started with 828 patients who were on the waiting list for LTx. Then, in a longitudinal follow-up, 370 post-LTx patients were evaluated annually for up to 15 years. For all wait-listed and follow-up patients, the following four HRQoL instruments were administered: State-Trait Anxiety Inventory, Zung Self-rating Depression Scale, Nottingham Health Profile, and a visual analogue scale. Cross-sectional and generalized estimating equation (GEE) analysis for repeated measures were performed to assess changes in HRQoL during follow-up. After LTx, patients showed improvement in all HRQoL domains except pain, which remained steady throughout the long-term follow-up. The level of anxiety and depressive symptoms decreased significantly and remained constant. In conclusion, this study showed that HRQoL improves after LTx and tends to remain relatively constant for the entire life span.

Keywords: clinical research/practice; epidemiology; health services and outcomes research; lung transplantation/pulmonology; qualitative research; quality of life (QOL).

Figure 1

Scheme of study inclusion and follow‐up (LTx, lung transplantation)

Figure 2

Reversed mean scores for depressive symptoms (Zung) by gender

Figure 3

Reversed mean scores for physical activity and energy domains of HRQoL (NHP) by gender [Color figure can be viewed at wileyonlinelibrary.com]