%0 Journal Article
%T Impact of Identification and Treatment of Depression in Heart Transplant Patients
%A Ike Okwuosa
%A Dara Pumphrey
%A Jyothy Puthumana
%A Rachel-Maria Brown
%A William Cotts
%J Cardiovascular Psychiatry and Neurology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/747293
%X Background. The effects of clinical depression after orthotopic heart transplantation (OHT) are relatively unknown. The purpose of this study was to evaluate the impact of depression on outcomes after OHT. Methods. We performed a single center retrospective review of 102 consecutive patients who underwent OHT at Northwestern Memorial Hospital from June 2005 to October 2009. The diagnosis of depression was obtained from attending physician documentation. The primary endpoints were all-cause mortality (ACM), hospitalizations, and rejection. Results. Of 102 OHT patients, 26 (26%) had depression. Depressed patients were similar in age to nondepressed patients (57.6 years versus 56.9, ). There was no statistical difference in survival between groups at 5 years after OHT ( ). All-cause hospitalizations were higher in depressed versus nondepressed patients (4.3 versus 2.6 hospitalizations ). There were no significant differences in hospitalizations between the two groups for the following complications: cardiac (heart failure, edema, arrhythmias, and acute rejection) and infections. There was no significant difference in episodes of 2R and 3R rejection. Conclusion. Early identification and treatment of depression in OHT patients result in outcomes similar to nondepressed patients. 1. Introduction Heart failure is associated with significant resource utilization, accounting for nearly 1 million hospital admissions annually, placing a significant financial burden on the healthcare system [1]. In 2010 $24 billion were dedicated to care for heart failure patient; by 2030 that cost is projected to total $70 billion [2]. Similar to other chronic diseases such as diabetes mellitus and chronic obstructive pulmonary disease, depression affects an estimated 20% of heart failure patients [3¨C5], compared to the estimated 6.6% amongst the general population [6]. OHT is definitive and the best treatment option available for patients with end stage heart failure. Following heart transplantation patients report improved functional capacity and overall quality of life; however this varies based on severity of illness before transplant [7, 8]. A significant portion of patients after OHT experience depression (estimated prevalence of 20¨C30%) [9, 10]. Independently, depression has been associated with increased resource utilization. It is estimated that depression is responsible for $34 billion in direct and indirect costs annually [11]. In patients with chronic diseases, depression has been associated with increased morbidity and mortality, when compared to nondepressed patients
%U http://www.hindawi.com/journals/cpn/2014/747293/