Prognostic value of psychosocial factors for first and recurrent hospitalizations and mortality in heart failure patients: insights from the OPERA-HF study

Sokoreli, I; Pauws, S. C.; Steyerberg, E. W.; de Vries, Gert-Jan; Riistama, J. M.; Tesanovic, A.; Kazmi, S.; Pellicori, P.; Cleland, John G.; Clark, A. L.

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 which 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 (re-admissions or death).
Of 671 patients (age 76±15 years, 66% men) with one-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, the presence of co-morbidities (diabetes, history of MI, COPD), were all associated with increasing risk of first or recurrent event. 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.

Citation

Sokoreli, I., Pauws, S. C., Steyerberg, E. W., de Vries, G., Riistama, J. M., Tesanovic, A., …Clark, A. L. (2018). Prognostic value of psychosocial factors for first and recurrent hospitalizations and mortality in heart failure patients: insights from the OPERA-HF study. European journal of heart failure, 20(4), 689-696. https://doi.org/10.1002/ejhf.1112

• Journal Article Type: Article
• Acceptance Date: Nov 20, 2017
• Online Publication Date: Jan 4, 2018
• Publication Date: Apr 1, 2018
• Deposit Date: Jul 6, 2018
• Publicly Available Date: Jan 5, 2019
• Print ISSN: 1388-9842
• Electronic ISSN: 1879-0844
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 20
• Issue: 4
• Pages: 689-696
• DOI: https://doi.org/10.1002/ejhf.1112
• Keywords: Heart failure; Readmission; Mortality; Recurrent events; Psychosocial factors; Frailty
• Public URL: https://hull-repository.worktribe.com/output/914631
• Publisher URL: https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.1112
• Related Public URLs: http://eprints.gla.ac.uk/154305/
• Contract Date: Jul 6, 2018