Ioanna Sokoreli1,2, Steffen C Pauws1,3, Ewout W Steyerberg2,4, Gert-Jan de Vries1, Jarno M Riistama1, Aleksandra Tesanovic1, Syed Kazmi5, Pierpaolo Pellicori5, John G Cleland5,6,7, Andrew L Clark5. 1. Philips Research - Healthcare, Eindhoven, The Netherlands. 2. Department of Public Health, Centre for Medical Decision Making, Erasmus MC, Rotterdam, The Netherlands. 3. TiCC - University of Tilburg, Tilburg, The Netherlands. 4. Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands. 5. University of Hull, Hull, UK. 6. National Heart & Lung Institute, Imperial College, London, UK. 7. Robertson Centre for Biostatistics & Clinical Trials, University of Glasgow, Glasgow, UK.
Abstract
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.
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.
Authors: Panagiotis Savvoulidis; James V Snider; Sahil Rawal; Alanna A Morris; Javed Butler; Vasiliki V Georgiopoulou; Andreas P Kalogeropoulos Journal: Int J Cardiol Date: 2019-11-06 Impact factor: 4.164
Authors: Hanzhang Xu; Heather R Farmer; Bradi B Granger; Kevin L Thomas; Eric D Peterson; Matthew E Dupre Journal: Circ Cardiovasc Qual Outcomes Date: 2021-01-12
Authors: Zachary K Wegermann; Michael J Mack; Suzanne V Arnold; Christin A Thompson; Michael Ryan; Candace Gunnarsson; Susan Strong; David J Cohen; Karen P Alexander; J Matthew Brennan Journal: J Am Heart Assoc Date: 2022-04-26 Impact factor: 6.106