Recovery of dialysis patients with COVID-19 : health outcomes 3 months after diagnosis in ERACODA

Background. Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. Methods. We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. Results. In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8-6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. Conclusions. Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis

Using GI-specific patient outcome measures in renal transplant patients: Validation of the GSRS and GIQLI

IntroductionGastrointestinal (GI) side-effects occur frequently as a result of immunosuppressant regimens used in renal transplant patients. Little effort has been made to quantify the impact of these side-effects on patients' health-related quality of life and symptom severity.ObjectiveTo assess the psychometric characteristics of two GI-specific outcome instruments (the Gastrointestinal Rating Scale (GSRS) and the Gastrointestinal Quality of Life Index (GIQLI)) for use in post-renal transplant patients.MethodsCross-sectional study conducted at 5 clinical centers in 4 countries. Patients were required to be on mycophenolate mofetil and a calcineurin inhibitor. Patients completed the GSRS, GIQLI and two generic instruments (the Psychological General Well-Being Index and the EQ-5D) at one timepoint. Reliability, construct and known groups validity were assessed.ResultsIn general the GSRS and the GIQLI demonstrated Cronbach's alphas higher than 0.70. The GIQLI was moderately to highly correlated with the PGWB and EQ-5D. Correlations among the GSRS and generic instruments were slightly lower. The GSRS and GIQLI both distinguished between patients with and without GI complaints (all pConclusionsThe GSRS and the GIQLI are appropriate for use in a post-renal transplant population. Scores on both instruments demonstrated significant differences between renal transplant patients with GI complications and without GI complications

Fragebogen zur psychischen Verarbeitung einer Organtransplantation: Deutsche Validierung des Transplant Effects Questionnaire (TxEQ)

Fragestellung: In der vorliegenden Arbeit wird untersucht, (a) ob die deutsche Version des Transplant Effects Questionnaire (TxEQ-D), welcher die psychische Verarbeitung einer Organtransplantation erfasst und Hinweise zur Indikation psychosozialer Interventionen liefert, die gleiche faktorielle Struktur wie die englische Originalversion aufweist und (b) ob die Skalenkennwerte sowie die Korrelationen mit den Skalen des SF-36 (Fragebogen zum physischen und psychischen Gesundheitszustand) vergleichbar sind. Methode: Der ins Deutsche übersetzte Fragebogen TxEQ wurde von einer Stichprobe von 370 herz-, lungen-, leber- und nierentransplantierten Patienten ausgefüllt und einer Faktoren- sowie Itemanalyse unterzogen. Zudem wurde zur Prüfung der Validität der Lebensqualitäts-Fragebogen SF-36 eingesetzt. Ergebnisse: Der TxEQ-D hat die gleiche faktorielle Struktur wie die englische Originalversion und vergleichbare psychometrische Eigenschaften. Die höchsten Korrelationen mit den 10 Skalen des SF-36 weist der Faktor »Sorge um das Transplantat« auf, die niedrigsten der Faktor »Adherence«. Schlussfolgerungen: Der TxEQ-D ist ein für die psychosomatische Forschung und psychotherapeutische Praxis geeignetes Screeningintrument zur Erkennung von Patienten mit einer problematischen psychischen Verarbeitung einer Organtransplantation, die zusätzlich zur somatischen Nachbehandlung professionelle psychosoziale Unterstützung erhalten sollten. = Objectives: The present study investigates a) whether the German version of the Transplant Effects Questionnaire (TxEQ-D), which measures the emotional response to an organ transplantation, has the same factorial structure as the English original version and b) whether the psychometric properties as well as the correlations with the scales of the SF-36 are comparable. Methods: The questionnaire TxEQ was translated into German and filled out by 370 heart, lung, liver and kidney transplant patients. Subsequently, factor and item analyses were conducted. The SF-36 was used to test validity. Results: The TxEQ-D has the same factorial structure as the English version as well as comparable psychometric properties. The TxEQ-D factor “worry about transplant” shows the highest correlations with the 10 scales of the SF-36, the lowest correlations with the 10 scales of the SF-36 scales are found for the factor “adherence”. Conclusions: The TxEQ-D is a useful screening instrument in psychosomatic research and in the psychotherapy practice to detect patients with problematic emotional responses to an organ transplantation