Associations of Pretransplant Patient-Reported Outcomes Measurement Information System Physical Function Score With Kidney Transplant Outcomes

Abstract

Simple and validated physical function measures are needed for kidney transplant candidates because pretransplant low physical function is a common and potentially modifiable risk factor. This single-center retrospective study investigated the associations between pretransplant physical function assessed by the Patient-Reported Outcomes Measurement Information System^® Physical Function (PROMIS-PF) computer adaptive testing and early posttransplant outcomes. We analyzed 154 adult kidney-alone transplant recipients. The median pretransplant PROMIS-PF score was 43 (interquartile range, 39-47). Patient characteristics were not significantly different across the score category (normal, score ≥45; mild, score of 40-45; and moderate/severe, score <40). The PROMIS-PF score was not associated with length of transplant hospital stay, delayed graft function, 6-month and 12-month graft function, or 12-month patient and graft survival. However, a lower PROMIS-PF score was significantly associated with a higher risk of emergency room visits [adjusted odds ratios compared to normal: mild, 1.68 (95% confidence interval, 0.76-3.83); moderate/severe, 3.23 (1.34-7.79)] and rehospitalization [adjusted odds ratios: mild, 2.61 (1.16-5.90); moderate/severe, 2.53 (1.07-6.00)] within 1 month posttransplant. Results suggest that PROMIS-PF is a practical tool for assessing physical function in kidney transplant candidates. Larger studies are needed to confirm the utility of PROMIS-PF to identify transplant candidates who would benefit from pretransplant prehabilitation.

Keywords: PROMIS®; Patient-Reported Outcomes Measurement Information System®; kidney transplantation; physical function; transplant outcomes.

FIGURE 1

Study flowchart. PROMIS PF, Patient-Reported Outcomes Measurement Information System Physical Function.