Sheila M Manemann1, Alanna M Chamberlain1, Cynthia M Boyd2, Yariv Gerber1,3, Shannon M Dunlay1,4, Susan A Weston1, Ruoxiang Jiang1, Véronique L Roger1,4. 1. Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota. 2. Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, Maryland. 3. Department of Epidemiology and Preventive Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel. 4. Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Abstract
OBJECTIVES: To investigate the effect of the number and type of comorbid conditions on death and hospitalizations in individuals with incident heart failure (HF). DESIGN: Population-based cohort study. SETTING: Olmsted County, Minnesota. PARTICIPANTS: Olmsted County, Minnesota, residents with incident HF from 2000 to 2010 (mean age 76 ± 14, 56% female) (N = 1,714). MEASUREMENTS: The prevalence of 16 chronic conditions obtained at HF diagnosis classified into three groups: cardiovascular (CV) related, other physical, and mental. RESULTS: The mean number of conditions per participant was 2.6 ± 1.5 for CV-related conditions, 1.3 ± 1.1 for other physical conditions, and 0.30 ± 0.61 for mental conditions. After a mean follow-up of 4.2 years, 1,073 deaths and 6,306 hospitalizations had occurred. After adjustment for age, sex, ejection fraction, in- or outpatient status, and number of other conditions, an increase of one other physical condition was associated with a 14% (HR = 1.14, 95% CI = 1.08-1.20) greater risk of death and a 26% (HR = 1.26, 95% CI = 1.20-1.32) greater risk of hospitalization, and an increase of one mental condition was associated with a 31% (HR = 1.31, 95% CI = 1.19-1.44) greater risk of death and an 18% (HR = 1.18, 95% CI = 1.07-1.29) greater risk of hospitalization. In contrast, an increase of one CV-related condition was not associated with greater risk of death and was associated with a 10% (HR = 1.10, 95% CI = 1.06-1.15) greater risk of hospitalization. CONCLUSION: CV-related conditions are the most common type of comorbid conditions in individuals with HF, but other physical and mental conditions are more strongly associated with death and hospitalizations. This underscores the effect of non-CV conditions on outcomes in HF.
OBJECTIVES: To investigate the effect of the number and type of comorbid conditions on death and hospitalizations in individuals with incident heart failure (HF). DESIGN: Population-based cohort study. SETTING: Olmsted County, Minnesota. PARTICIPANTS: Olmsted County, Minnesota, residents with incident HF from 2000 to 2010 (mean age 76 ± 14, 56% female) (N = 1,714). MEASUREMENTS: The prevalence of 16 chronic conditions obtained at HF diagnosis classified into three groups: cardiovascular (CV) related, other physical, and mental. RESULTS: The mean number of conditions per participant was 2.6 ± 1.5 for CV-related conditions, 1.3 ± 1.1 for other physical conditions, and 0.30 ± 0.61 for mental conditions. After a mean follow-up of 4.2 years, 1,073 deaths and 6,306 hospitalizations had occurred. After adjustment for age, sex, ejection fraction, in- or outpatient status, and number of other conditions, an increase of one other physical condition was associated with a 14% (HR = 1.14, 95% CI = 1.08-1.20) greater risk of death and a 26% (HR = 1.26, 95% CI = 1.20-1.32) greater risk of hospitalization, and an increase of one mental condition was associated with a 31% (HR = 1.31, 95% CI = 1.19-1.44) greater risk of death and an 18% (HR = 1.18, 95% CI = 1.07-1.29) greater risk of hospitalization. In contrast, an increase of one CV-related condition was not associated with greater risk of death and was associated with a 10% (HR = 1.10, 95% CI = 1.06-1.15) greater risk of hospitalization. CONCLUSION: CV-related conditions are the most common type of comorbid conditions in individuals with HF, but other physical and mental conditions are more strongly associated with death and hospitalizations. This underscores the effect of non-CV conditions on outcomes in HF.
Authors: Jennifer L St Sauver; Brandon R Grossardt; Cynthia L Leibson; Barbara P Yawn; L Joseph Melton; Walter A Rocca Journal: Mayo Clin Proc Date: 2012-02 Impact factor: 7.616
Authors: Alan S Go; Dariush Mozaffarian; Véronique L Roger; Emelia J Benjamin; Jarett D Berry; Michael J Blaha; Shifan Dai; Earl S Ford; Caroline S Fox; Sheila Franco; Heather J Fullerton; Cathleen Gillespie; Susan M Hailpern; John A Heit; Virginia J Howard; Mark D Huffman; Suzanne E Judd; Brett M Kissela; Steven J Kittner; Daniel T Lackland; Judith H Lichtman; Lynda D Lisabeth; Rachel H Mackey; David J Magid; Gregory M Marcus; Ariane Marelli; David B Matchar; Darren K McGuire; Emile R Mohler; Claudia S Moy; Michael E Mussolino; Robert W Neumar; Graham Nichol; Dilip K Pandey; Nina P Paynter; Matthew J Reeves; Paul D Sorlie; Joel Stein; Amytis Towfighi; Tanya N Turan; Salim S Virani; Nathan D Wong; Daniel Woo; Melanie B Turner Journal: Circulation Date: 2013-12-18 Impact factor: 29.690
Authors: Christopher E Kurtz; Yariv Gerber; Susan A Weston; Margaret M Redfield; Steven J Jacobsen; Véronique L Roger Journal: Mayo Clin Proc Date: 2006-07 Impact factor: 7.616
Authors: Barbara J Turner; Christopher S Hollenbeak; Mark Weiner; Thomas Ten Have; Simon S K Tang Journal: Ann Intern Med Date: 2008-04-15 Impact factor: 25.391
Authors: Richard A Goodman; Samuel F Posner; Elbert S Huang; Anand K Parekh; Howard K Koh Journal: Prev Chronic Dis Date: 2013-04-25 Impact factor: 2.830
Authors: Mayra Tisminetzky; Jerry H Gurwitz; Dongjie Fan; Kristi Reynolds; David H Smith; Hassan Fouayzi; Sue Hee Sung; Robert Goldberg; Alan S Go Journal: J Gerontol A Biol Sci Med Sci Date: 2020-09-25 Impact factor: 6.053
Authors: Sheila M Manemann; Alanna M Chamberlain; Cynthia M Boyd; Donna M Miller; Kimberly L Poe; Andrea Cheville; Susan A Weston; Ellen E Koepsell; Ruoxiang Jiang; Véronique L Roger Journal: Circ Cardiovasc Qual Outcomes Date: 2018-08
Authors: Meghan Reading Turchioe; Lisa V Grossman; Dawon Baik; Christopher S Lee; Mathew S Maurer; Parag Goyal; Monika M Safford; Ruth M Masterson Creber Journal: J Am Geriatr Soc Date: 2020-03-10 Impact factor: 5.562
Authors: Sheila M Manemann; Alanna M Chamberlain; Véronique L Roger; Cynthia Boyd; Andrea Cheville; Shannon M Dunlay; Susan A Weston; Ruoxiang Jiang; Lila J Finney Rutten Journal: J Am Geriatr Soc Date: 2018-03-30 Impact factor: 5.562
Authors: Himali Weerahandi; Erin L Chaussee; John A Dodson; Mary Dolansky; Rebecca S Boxer Journal: J Am Med Dir Assoc Date: 2021-09-01 Impact factor: 4.669