Living Alone and Gender Differences in Rehospitalization for Heart Failure After Discharge Among Acute Heart Failure Patients

Takabayashi, Kensuke; Kitaguchi, Shouji; Iwatsu, Kotaro; Ikeda, Tsutomu; Fujita, Ryoko; Okuda, Miyuki; Nakajima, Osamu; Koito, Hitoshi; Terasaki, Yuka; Kitamura, Tetsuhisa; Nohara, Ryuji

doi:10.1536/ihj.20-386

Cited by 6 publications

(8 citation statements)

References 25 publications

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“…Another study from Schockmel et al also included only patients with HFpEF 18 . A prospective, multicenter, community‐based cohort from Japan included only patients with acute HF 19 . To assess the quality of cohort studies, we employed the NOS tool.…”

Section: Resultsmentioning

confidence: 99%

“…8,24,25 More recently, seven studies assessed the relationship between living alone and the risk of hospitalization or death. [11][12][13][16][17][18][19] Huynh et al investigated the determinants of rehospitalization or mortality in patients hospitalized for HF in the 30 days after discharge (either HFpEF or HFrEF). 12 Living alone raised the risk of hospitalization or death after adjusting for covariates.…”

Section: Living Alone and Any Hospitalization Or Deathmentioning

confidence: 99%

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Association of living alone with clinical outcomes in patients with heart failure: A systematic review and meta‐analysis

Chen,

Liu,

Luo

et al. 2023

Clinical Cardiology

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Living alone is an objective sign of social isolation. It is uncertain whether living alone worsens clinical outcomes in heart failure (HF) patients. We aimed to assess how living alone affected clinical outcomes in individuals with HF. We searched the electronic databases of PubMed, Embase, and Cochrane from 1990 to April 2022 for studies comparing living alone with HF. A random‐effects model with inverse variance was used to pool adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Seven studies were deemed to meet the standards. In patients with HF, compared with living with others, living alone was associated with an elevated risk of any hospitalization at the 30‐day (HR: 1.78, 95% CI: 1.09–2.89), 90‐day (HR: 1.24, 95% CI: 1.02–1.51), or ≥1‐year (HR: 1.14, 95% CI: 1.04–1.26) follow‐up periods. HF patients living alone also had a greater risk of any hospitalization or death at the 30‐day (HR: 1.56, 95% CI: 1.15–2.11), 90‐day (HR: 1.26, 95% CI: 1.05–1.50), and ≥1‐year (HR: 1.18, 95% CI: 1.09–1.28) follow‐up periods. However, patients living alone had no increased risk of all‐cause death at the 30‐day (HR: 1.0, 95% CI: 0.19–5.36), 90‐day (HR: 0.46, 95% CI: 0.03–7.42), or ≥ 1‐year (HR: 1.10, 95% CI: 0.73–1.67) follow‐up periods. In comparison to living with others, living alone was associated with an increased risk of any hospitalization but not all‐cause death in HF patients.

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Section: Resultsmentioning

confidence: 99%

Section: Living Alone and Any Hospitalization Or Deathmentioning

confidence: 99%

Association of living alone with clinical outcomes in patients with heart failure: A systematic review and meta‐analysis

Chen,

Liu,

Luo

et al. 2023

Clinical Cardiology

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“…Exceptionally, living alone is a marker for social isolation that has been widely adopted. In Japan, the prevalence of living alone was reported to be 9-18% in community-dwelling older adults [11][12][13][14] and 15-21% in patients with cardiovascular diseases [15][16][17][18][19] . The corresponding prevalence in the study population was 24.5% (95% CI 20.1-28.8%), suggesting that the prevalence was at least not lower (or possibly slightly higher) than in other populations.…”

Section: Discussionmentioning

confidence: 99%

Social isolation in patients with chronic limb-threatening ischemia: a cross-sectional study

Takahara

Iida

Ohura

et al. 2023

Sci Rep

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Assistance by family members or friends plays important roles in the course of treating patients with chronic limb-threatening ischemia (CLTI), both during hospitalization and after discharge. The aim of this study was to reveal the prevalence of social isolation and to explore relevant clinical backgrounds in patients with CLTI presenting with tissue loss and requiring revascularization. We analyzed 413 patients registered in a multicenter study in whom revascularization were scheduled for CLTI with tissue loss. Social isolation was analyzed by assessing the residence status of the patients and the involvement of a trusted family member or friend in their daily lives and during hospitalization. Patients living alone accounted for 24.5% (95% confidence interval [CI] 20.1–28.8%) of the study population. Patients receiving welfare were more likely to live alone (P < 0.001). For patients living alone, 21.8% (95% CI 12.8–30.8%) met a trusted family member or friend in their daily lives less than once per year. Younger age and receiving welfare were independently associated with lower frequency of meeting the trusted person in their daily lives (both P < 0.05). The adjusted odds ratio of age and receiving welfare was 0.44 (95% CI 0.29–0.67) per 10-year increase and 3.47 (95% CI 1.43–8.44), respectively. During hospitalization, 9.9% (95% CI 6.8–13.0%) of the patients had no hospital visits by a trusted family member or friend on three key occasions: the patient’s first hospital visit, the preoperative explanation regarding the planned operation, and the day of the operation. Younger age and receiving welfare were independently associated with lower frequency of hospital visits by a family member or friend (both P < 0.05). The adjusted odds ratio of age and receiving welfare for no visit versus ≥ 1 visit was 0.51 (0.36–0.74) per 10-year increase and 5.29 (2.46–11.4), respectively. In conclusion, social isolation is common among patients with CLTI, especially younger patients and those on welfare. Practical countermeasures against social isolation are warranted in the management of CLTI.

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“…A past study reported that living alone was a risk factor for the advanced disability and a poorer prognosis [ 24 ]. Recently, living alone after the first HF discharge was reported to be a risk for rehospitalization for HF in men, but not in women [ 25 ]. Although HF-ACTION study, which enrolled patients with chronic HF between 2003 and 2007 in a Western country, retrospectively showed that having a partner was not an independent predictor of long-term clinical outcomes [ 26 ], the patients in this study were relatively young and self-care disabilities were not conspicuous.…”

Section: Discussionmentioning

confidence: 99%

Gender difference in heart failure with preserved ejection fraction: clinical profiles, examinations, and prognosis

Sakai¹,

Motoki

Suzuki

et al. 2022

Heart Vessels

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Heart failure with preserved ejection fraction (HFpEF) has currently become a major concern in the aging society owing to its substantial and growing prevalence. Recent investigations regarding sacubitril/valsartan have suggested that there is a gender difference in the efficacy of the medication in HFpEF cohort. However, information of gender difference in clinical profiles, examination, and prognosis have not been well investigated. The present study aimed to evaluate the differences in baseline characteristics and outcomes between women and men in a Japanese HFpEF cohort. We analyzed the data from our prospective, observational, and multicenter cohort study. Overall, 1036 consecutive patients hospitalized for acute decompensated heart failure were enrolled. We defined patients with an ejection fraction (EF) of ≥ 50% as HFpEF. Patients with severe valvular disease were excluded; the remaining 379 patients (women: n = 201, men: n = 178) were assessed. Women were older than men [median: 85 (79–89) years vs. 83 (75–87) years, p = 0.013]. Diabetes mellitus, hyperuricemia, and coronary artery disease were more prevalent in men than in women (34.8% vs. 23.9%, p = 0.019, 23.6% vs. 11.4%, p = 0.002, and 23.0% vs. 11.9%, p = 0.005, respectively). EF was not significantly different between women and men. The cumulative incidence of cardiovascular death or hospitalization for congestive heart failure (CHF) was significantly lower in women than in men (log-rank p = 0.040). Women with HFpEF were older and less often exhibited an ischemic etiology; further, they were associated with a lower risk for cardiovascular death or hospitalization for CHF compared with men in the Japanese population.

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Living Alone and Gender Differences in Rehospitalization for Heart Failure After Discharge Among Acute Heart Failure Patients

Cited by 6 publications

References 25 publications

Association of living alone with clinical outcomes in patients with heart failure: A systematic review and meta‐analysis

Association of living alone with clinical outcomes in patients with heart failure: A systematic review and meta‐analysis

Social isolation in patients with chronic limb-threatening ischemia: a cross-sectional study

Gender difference in heart failure with preserved ejection fraction: clinical profiles, examinations, and prognosis

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