Association between depression and readmission of heart failure: A national representative database study

Patel, Neelkumar; Chakraborty, Sanjoy; Bandyopadhyay, Dhrubajyoti; Amgai, Birendra; Hajra, Adrija; Atti, Varunsiri; Das, Avash; Ghosh, Raktim; Deedwania, Prakash; Aronow, Wilbert S.; Lavie, Carl J.; Tullio, Marco R. Di; Vaduganathan, Muthiah; Fonarow, Gregg C.

doi:10.1016/j.pcad.2020.03.014

Cited by 24 publications

(14 citation statements)

References 29 publications

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“…Remarkably, survival curves revealed that the depressive symptoms group had a significantly higher risk of endpoint events than the group of nondepressive symptoms (P < 0.001). In a retrospective study involving 3 500 570 patients with HF, Patel et al 21 discovered that the presence of depression is associated with increased all-cause readmission within 30 and 90 days, driven primarily by psychiatric causes but not cardiac readmission, suggesting that standardized HF treatment failed to modify this portion of all-cause readmission, further demonstrating the importance of paying attention to depressive symptoms in patients with HF. Depression is now widely recognized as an independent risk factor for poor prognosis in patients with HF.…”

Section: Discussionmentioning

confidence: 99%

Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors

et al. 2022

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AimsThis study aims to analyse the factors associated with prognosis in hospitalized patients with heart failure, particularly the role of depressive symptoms, and to develop a prediction model for depressive symptoms based on clinical characteristics in hospitalized patients with heart failure. Methods and results Baseline information was collected at admission, and patients were followed up after discharge. The endpoint events were being hospitalized for heart failure or all-cause death. Depressive symptoms were evaluated and defined via the Patient Health Questionnaire (PHQ)-2 and PHQ-9. The bidirectional elimination was used to screen independent predictors of heart failure with depression symptoms. The least absolute shrinkage and selection operator (LASSO) optimized the predictor variables, and the prediction model was constructed. The model was internally validated by the bootstrap sampling method (Bootstrap), and its performance was assessed by discrimination and calibration. The mean age of patients with heart failure was 69.43 ± 12.15 years, and the proportion of males was 66.67%. The prevalence of depressive symptoms in hospitalized patients with heart failure was 46.83%, and the prevalence of moderate/severe depressive symptoms was 11.62%. Eighty cases (30.30%) were readmitted for heart failure, and 13 cases (4.92%) were all-cause deaths. Depressive symptoms (HR = 2.43, 95% CI: 1.55-3.80) and the PHQ-9 score (HR = 1.11, 95% CI: 1.06-1.16) were both independent risk factors for endpoint events (P < 0.001). For heart failure patients combined with depressive symptoms, obesity (OR = 0.27, 95% CI: 0.09-0.77, P = 0.015), N-terminal brain natriuretic peptide precursor (NT-proBNP) level (lnNT-proBNP: OR = 1.55, 95% CI: 1.20-2.01, P < 0.001) and red blood cell distribution width (RDW) (OR = 1.26, 95% CI: 1.08-1.47, P = 0.004) were the independent factors. Six variables, including cardiovascular disease hospitalization history, obesity, renal insufficiency, NT-proBNP level, neutrophil ratio and RDW, were included to construct the prediction model. The area under the curve (AUC) was 0.730 in the original data, and the calibration curve was approximately distributed along the reference line in Bootstrap (500 resamplings), indicating the high level of discrimination and calibration of this model. Conclusions Depressive symptoms and the PHQ-9 score are both independent risk factors for the prognosis of hospitalized patients with heart failure. In hospitalized patients with heart failure, the risk prediction model developed in this study has good predictive power for depressive symptoms.

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Section: Discussionmentioning

confidence: 99%

Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors

et al. 2022

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“…This result was similar to the prevalence studies done during 2007 to 2010 in the United States that showed nearly a two-fold higher risk of hospital admission and emergency department visits and a four-fold increase in mortality in HF patients with moderate to severe depression [2]. However, data from 2010 to 2014 from the Nationwide Readmission Database, which included approximately 60% of hospitalized patients in the United States, showed only a modest increase in readmission rates in patients with depression after adjusting for other comorbidities [3]. Similarly, a Danish database from 1995 to 2014 showed a modest increase in mortality in heart failure patients with depression [4].…”

Section: Introductionmentioning

confidence: 99%

Association of Major Depressive Disorder on Heart Failure With Reduced and Preserved Ejection Fraction: Analysis of National Readmission Database 2018

Thyagaturu¹,

Thangjui²,

Shah³

et al. 2021

Cureus

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The effect of major depressive disorder (MDD) on heart failure types is unclear. We aimed to assess the association of depression in heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) readmissions using the Nationwide Readmission Database (NRD) 2018. MethodsWe identified hospitalizations with a primary discharge diagnosis of HFrEF and HFpEF by appropriate ICD-10-CM codes. We acquired mortality and readmission data with and without MDD at 30 days. We used multivariate logistic regression analysis to estimate the adjusted odds ratio (aOR). ResultsAmong 102,997 patients admitted with heart failure as a primary diagnosis, 11% had MDD. We found a similar prevalence of HFpEF with MDD compared to HFrEF at 13.9% and 10%, respectively. Both HFrEF and HFpEF patients with MDD had similar combined outcomes of 30-day mortality and rehospitalization compared to patients without MDD with aOR 0.94 (95% CI: 0.85-1.04) and 0.93 (95% CI: 0.81-1.07), respectively. Both types of HF with MDD were associated with lesser mortality. ConclusionMDD was associated with similar combined 30-day mortality and readmissions for both HFrEF and HFpEF. However, MDD was associated with decreased 30-day mortality in both groups of heart failure (HF) patients. Further studies with robust medications and treatment data are needed to verify the results of our study.

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“…It was apparent through a review of the literature that depression and anxiety had a devastating impact on patients with HF (Alemoush et al , 2021; Mueller-Tasch et al ,2018; Gathright et al , 2017; Sokoreli et al , 2018; Xu et al , 2018). Previous studies showed that depression is considered a risk factor for rehospitalization in patients with HF (Patel et al , 2020; Freedland et al ,2016; Ma, 2019; Alhurani et al , 2015; Ahmedani et al , 2015). Patel et al (2020) identified that depression was associated with a higher risk of all-cause rehospitalization within 30 and 90 days due to many symptoms of depression, such as fatigue, social isolation and lack of motivation, might affect medication adherence with decreased physical activity and increased use of tobacco in patients with HF (Patel et al , 2020).…”

Section: Resultsmentioning

confidence: 99%

Depression and anxiety in patients with heart failure: contributing factors, consequences and coping mechanisms: a review of the literature

Sumaqa

Hayajneh

2022

WWOP

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Purpose The purpose of this study is to integrate evidence on contributing factors, consequences, in addition to coping mechanisms of depression and anxiety in patients with heart failure. Design/methodology/approach An integrative review was conducted by searching three main electronic databases: Web of Sciences, MEDLINE and Science Direct. Twenty-four studies met the inclusion criteria and were included in the final review process. Findings The review identified the most common contributing factors, consequences and coping mechanisms of depression and anxiety in patients with heart failure. Patients with heart failure have high anxiety and depression prevalence rates. Originality/value It is recommended to include routine assessment and management of anxiety and depression in heart failure protocols to improve clinical outcomes.

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Association between depression and readmission of heart failure: A national representative database study

Cited by 24 publications

References 29 publications

Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors

Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors

Association of Major Depressive Disorder on Heart Failure With Reduced and Preserved Ejection Fraction: Analysis of National Readmission Database 2018

Depression and anxiety in patients with heart failure: contributing factors, consequences and coping mechanisms: a review of the literature

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