肺移植后睡眠障碍与患者报告的结果更差以及慢性肺移植异位功能障碍有关
Aric A Prather1, Ying Gao2, Legna Betancourt2
1Department of Psychiatry and Behavioral Sciences, University of California, San Francisco.
medRxiv : the preprint server for health sciences
|October 24, 2023
概括
肺移植后睡眠质量差与患者的治疗结果更差有关,包括慢性肺异位移植功能障碍和死亡风险增加. 解决睡眠问题可能会改善肺移植的成功.
科学领域:
- 移植手术 移植手术
- 肺部病理学 肺部病理学
- 睡眠医学 睡眠医学
背景情况:
- 肺移植接受者经常经历低于最佳的功能和生存结果.
- 睡眠障碍是研究不足的,但可能对肺移植成功产生影响的因素.
研究的目的:
- 为了研究睡眠质量与患者报告的结果 (PROs),虚弱和肺移植后的临床终点 (CLAD,死亡) 之间的关联.
- 确定肺移植受体中睡眠障碍的外科预测因素.
主要方法:
- 141名肺移植接受者完成了MOS睡眠量表 (产生SPI和失眠子量表) 和PRO测量.
- 使用碎的脆弱现象型来评估脆弱性.
- 线性和考克斯回归模型分析了睡眠,PRO,虚弱,CLAD和死亡率之间的关联,并对共变量进行了调整.
主要成果:
- 移植后更长的住院时间 (>30天) 与更糟糕的睡眠 (SPI和失眠) 相相关.
- 较差的睡眠 (SPI和失眠) 与更严重的抑郁症,认知功能,HRQL,身体残疾,健康公用事业和脆弱性有关.
- 最糟糕的SPI和失眠四分位数增加了CLAD风险;SPI恶化也增加了死亡风险.
结论:
- 通过SPI和失眠来评估睡眠不足,是肺移植接受者不良结果的重要预测因素.
- 睡眠质量会影响PROs,虚弱性和临床事件,如CLAD和死亡率.
- 这些发现表明,睡眠评估和干预对改善肺移植结果至关重要.
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