Oliver Mauthner1, Veerle Claes1, Jeremy Walston2, Sandra Engberg1,3, Isabelle Binet4, Michael Dickenmann5, Déla Golshayan6, Karine Hadaya7, Uyen Huynh-Do8, Stefano Calciolari9, Sabina De Geest1,10. 1. Institute of Nursing Science, University of Basel, Switzerland. 2. Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA. 3. School of Nursing, University of Pittsburgh, Pennsylvania, USA. 4. Clinic of Nephrology and Transplantation Medicine, Cantonal Hospital St Gallen, Switzerland. 5. Department for Transplantation-Immunology and Nephrology, University Hospital Basel, Switzerland. 6. Transplantation Centre and Transplantation Immunopathology Laboratory, University Hospital Lausanne, Switzerland. 7. Department of Nephrology, University Hospital Geneva, Switzerland. 8. University Clinic for Nephrology, Hypertension and Clinical Pharmacology, University Hospital Bern, Switzerland. 9. Institute of Economics, University of Lugano, Switzerland. 10. Academic Center for Nursing and Midwifery, KU Leuven, Belgium.
Abstract
AIM: To present the rationale, design and methodology of the GERAS project, which examines whether assessment of frailty and mild cognitive impairment could enhance risk prediction for biomedical, psychosocial outcomes and foster efficient resource allocation in kidney transplantation. BACKGROUND: For the burgeoning cohort of older patients considered for kidney transplantation, evidence gaps regarding frailty and mild cognitive impairment limit clinical decision-making and medical management. As known risk factors for 'hard' clinical outcomes in chronic illness, both require further study in transplantation. Integrating these and other bio-psychosocial factors into a comprehensive pre-transplant patient assessment will provide insights regarding economic implications and may improve risk prediction. DESIGN: A nation-wide multi-centre prospective cohort study nested in the Swiss Transplant Cohort Study. METHODS: Our nationally representative convenience sample includes 250 adult kidney transplant recipients. Data sources include the Swiss Transplant Cohort Study and primary data collected at time of transplantation, 6 months, 1 and 2 years post-transplant via established measures (the Montreal Cognitive Assessment, Psychosocial Questionnaire, Fried Frailty Instrument and a blood analysis), investigator-developed instruments and datasets compiled by hospitals' management control units, sickness funds, the Swiss Federal Statistical Office and the European Renal Association. Descriptive, competing risk survival and mixed effects analyses will be performed. Research Ethics Committee approval was obtained in January 2016. DISCUSSION: This pioneering project jointly examines frailty and mild cognitive impairment from bio-psychosocial and health economic perspectives. Results may significantly inform risk prediction, care tailoring and resource optimization to improve health outcomes in the ageing kidney transplant cohort.
AIM: To present the rationale, design and methodology of the GERAS project, which examines whether assessment of frailty and mild cognitive impairment could enhance risk prediction for biomedical, psychosocial outcomes and foster efficient resource allocation in kidney transplantation. BACKGROUND: For the burgeoning cohort of older patients considered for kidney transplantation, evidence gaps regarding frailty and mild cognitive impairment limit clinical decision-making and medical management. As known risk factors for 'hard' clinical outcomes in chronic illness, both require further study in transplantation. Integrating these and other bio-psychosocial factors into a comprehensive pre-transplant patient assessment will provide insights regarding economic implications and may improve risk prediction. DESIGN: A nation-wide multi-centre prospective cohort study nested in the Swiss Transplant Cohort Study. METHODS: Our nationally representative convenience sample includes 250 adult kidney transplant recipients. Data sources include the Swiss Transplant Cohort Study and primary data collected at time of transplantation, 6 months, 1 and 2 years post-transplant via established measures (the Montreal Cognitive Assessment, Psychosocial Questionnaire, Fried Frailty Instrument and a blood analysis), investigator-developed instruments and datasets compiled by hospitals' management control units, sickness funds, the Swiss Federal Statistical Office and the European Renal Association. Descriptive, competing risk survival and mixed effects analyses will be performed. Research Ethics Committee approval was obtained in January 2016. DISCUSSION: This pioneering project jointly examines frailty and mild cognitive impairment from bio-psychosocial and health economic perspectives. Results may significantly inform risk prediction, care tailoring and resource optimization to improve health outcomes in the ageing kidney transplant cohort.
Authors: Meera N Harhay; Maya K Rao; Kenneth J Woodside; Kirsten L Johansen; Krista L Lentine; Stefan G Tullius; Ronald F Parsons; Tarek Alhamad; Joseph Berger; XingXing S Cheng; Jaqueline Lappin; Raymond Lynch; Sandesh Parajuli; Jane C Tan; Dorry L Segev; Bruce Kaplan; Jon Kobashigawa; Darshana M Dadhania; Mara A McAdams-DeMarco Journal: Nephrol Dial Transplant Date: 2020-07-01 Impact factor: 5.992
Authors: Susanne Stampf; Nicolas J Mueller; Christian van Delden; Manuel Pascual; Oriol Manuel; Vanessa Banz; Isabelle Binet; Sabina De Geest; Pierre-Yves Bochud; Alexander Leichtle; Stefan Schaub; Jürg Steiger; Michael Koller Journal: BMJ Open Date: 2021-12-15 Impact factor: 2.692