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Prognostic value of psychosocial factors for first and recurrent hospitalizations and mortality in heart failure patients: insights from the OPERA‐HF study
Author(s) -
Sokoreli Ioanna,
Pauws Steffen C.,
Steyerberg Ewout W.,
de Vries GertJan,
Riistama Jarno M.,
Tesanovic Aleksandra,
Kazmi Syed,
Pellicori Pierpaolo,
Cleland John G.,
Clark Andrew L.
Publication year - 2018
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.1112
Subject(s) - medicine , psychosocial , heart failure , depression (economics) , anxiety , proportional hazards model , myocardial infarction , observational study , social support , psychiatry , economics , macroeconomics , psychology , psychotherapist
Aims Psychosocial factors are rarely collected in studies investigating the prognosis of patients with heart failure (HF), and only time to first event is commonly reported. We investigated the prognostic value of psychosocial factors for predicting first or recurrent events after discharge following hospitalization for HF. Methods and results OPERA‐HF is an observational study enrolling patients hospitalized for HF. In addition to clinical variables, psychosocial variables are recorded. Patients provide the information through questionnaires that include social information, depression and anxiety scores, and cognitive function. Kaplan–Meier, Cox regression and the Andersen–Gill model were used to identify predictors of first and recurrent events (readmissions or death). Of 671 patients (age 76 ± 15 years, 66% men) with 1‐year follow‐up, 291 had no subsequent event, 34 died without being readmitted, 346 had one or more unplanned readmissions, and 71 patients died after a first readmission. Increasing age, higher urea and creatinine, and the presence of co‐morbidities (diabetes, history of myocardial infarction, chronic obstructive pulmonary disease) were all associated with increasing risk of first or recurrent events. Psychosocial variables independently associated with both the first and recurrent events were: presence of frailty, moderate‐to‐severe depression, and moderate‐to‐severe anxiety. Living alone and the presence of cognitive impairment were independently associated only with an increasing risk of recurrent events. Conclusion Psychosocial factors are strongly associated with unplanned recurrent readmissions or mortality following an admission to hospital for HF. Further research is needed to show whether recognition of these factors and support tailored to individual patients' needs will improve outcomes.