Resource Utilization in Liver Transplant Patients Based on Psychological Evaluation of High Risk vs. Non-High Risk
1Transplant Surgery, Tampa General Hospital, Tampa, FL, 2Lake Erie College of Osteopathic Medicine, Bradenton, FL, 3University of South Florida, Tampa, FL, 4University of Tampa, Tampa, FL, 5Morsani College of Medicine, University of South Florida, Tampa, FL
Meeting: 2022 American Transplant Congress
Abstract number: 866
Keywords: Liver transplantation, Psychiatric comorbidity, Psychosocial
Topic: Clinical Science » Liver » 55 - Liver: Recipient Selection
Session Information
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-7:00pm
Location: Hynes Halls C & D
*Purpose: Psychological evaluation in liver transplant candidates helps to determine suitability. The psychological risk assessment results in the characterization of either low, medium, or high categories. We hypothesized that medium and high psychological risk assessment patients utilized greater hospital resources.
*Methods: We conducted a retrospective single-center cohort study of consecutive adult (age 18 or greater) deceased donor liver transplant patients from 2019 to 2020 who received a pre-transplant psychological evaluation. Patients transplanted without a psychological risk assessment were excluded from the analysis.
*Results: There were154 of 297 liver transplant patients included in the study with completed psychological risk assessments (79 low-risk and 80 high-risk). Pre-transplant, we found medium/high risk patients lacked more family support (26% vs. 5% vs 26, p=0.002), consumed more alcohol (86% vs. 19%, p=0.003), had more financial barriers (25% vs. 8%, p=0.005) and had more history of mental health issues (71% vs. 12%, p=0.005). Post-transplant, we found medium/high-risk patients utilized twice as many hospital resources compared with low-risk patients (p<0.001). There was a difference in utilization of inpatient care resources with medium/high-risk patients receiving more social worker intervention (40% vs. 19%, p=0.005), more alcohol disorder support (25% vs. 7%, p=0.002 and additional inpatient care (43% vs. 20%, p=0.003) compared with low-risk patients. We found no difference in the use of outpatient resources post-transplant between medium/high risk vs. low-risk patients including transportation services (14% vs. 14%, p=1.0), and housing (23% vs. 12%, p=0.499).
*Conclusions: Our study demonstrated medium/high-risk patients present with more mental health issues and require greater use of inpatient hospital resources compared with low-risk patients, but there was no difference between the groups for outpatient resource utilization post-transplant. This study suggests psychological evaluation is valuable to predict early intervention tools to ensure successful outcomes in medium/high-risk patients. Further research is indicated.
To cite this abstract in AMA style:
Barber K, Chism D, Sauls R, Shargo R, Gosselin M, Mohammed S, Robichaux K, Kumar A, Buggs J. Resource Utilization in Liver Transplant Patients Based on Psychological Evaluation of High Risk vs. Non-High Risk [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/resource-utilization-in-liver-transplant-patients-based-on-psychological-evaluation-of-high-risk-vs-non-high-risk/. Accessed November 21, 2024.« Back to 2022 American Transplant Congress