Loneliness in adults awaiting liver transplantation at 7 U.S. transplant centers
Kacey A Berry, Dorothea Kent, Srilakshmi Seetharaman, Randi Wong, Yara Mohamad, Frederick Yao, Maria Nunez-Duarte, Sharad I Wadhwani, Brian J Boyarsky, Robert S Rahimi, Andres Duarte-Rojo, Matthew R Kappus, Michael L Volk, Daniela P Ladner, Dorry L Segev, Mara McAdams-DeMarco, Elizabeth C Verna, Daniel R Ganger, Jennifer C Lai, Kacey A Berry, Dorothea Kent, Srilakshmi Seetharaman, Randi Wong, Yara Mohamad, Frederick Yao, Maria Nunez-Duarte, Sharad I Wadhwani, Brian J Boyarsky, Robert S Rahimi, Andres Duarte-Rojo, Matthew R Kappus, Michael L Volk, Daniela P Ladner, Dorry L Segev, Mara McAdams-DeMarco, Elizabeth C Verna, Daniel R Ganger, Jennifer C Lai
Abstract
Introduction: Loneliness, "a subjective feeling of being isolated", is a strong predictor of adverse health. We characterized loneliness in patients with end-stage liver disease (ESLD) awaiting liver transplantation (LT).
Methods: We surveyed loneliness in ambulatory ESLD adults awaiting LT at 7 U.S. sites using the validated UCLA Three-Item Loneliness Scale, May2020-Jan2021; "lonely"=total ≥5. Liver Frailty Index (LFI) assessed frailty; "frail"=LFI≥4.4. Logistic regression associated loneliness and co-variables.
Results: Of 454 participants, median MELDNa was 14 (IQR 10-19) and 26% met criteria for "lonely". Compared to those not lonely, those lonely were younger (57 v. 61y), more likely to be female (48% v. 31%) or frail (21 v. 11%), and less likely to be working (15% v. 26%) or in a committed partnership (52% v. 71%). After multivariable adjustment, frailty (OR=2.24, 95%CI=1.23-4.08), younger age (OR=1.19, 95%CI=1.07-1.34), female sex (OR=1.83, 95%CI=1.14-2.92), not working (OR=2.16, 95%CI=1.16-4.03), and not in a committed partnership (OR=2.07, 95%CI=1.29-3.32) remained significantly associated with higher odds of loneliness.
Conclusion: Loneliness is prevalent in adults awaiting LT, and independently associated with younger age, female sex and physical frailty. These data lay the foundation to investigate the extent to which loneliness impacts health outcomes in LT, as in the general population. Clinical Trial Registry Website: https://ichgcp.net/clinical-trials-registry/NCT03228290" title="See in ClinicalTrials.gov">NCT03228290.
Keywords: Cirrhosis; End-stage liver disease; Frailty; Mental health; Psychosocial; Quality of life; Social isolation; Social support.
Copyright © 2022 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.
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Source: PubMed