Depression and Multiple Rehospitalizations in Patients With Heart Failure

Clin Cardiol. 2016 May;39(5):257-62. doi: 10.1002/clc.22520. Epub 2016 Feb 3.

Abstract

Background: There have been few studies of the effect of depression on rehospitalization in patients with heart failure (HF), and even fewer on its role in multiple rehospitalizations.

Hypothesis: Depression is an independent risk factor for multiple readmissions in patients with HF.

Methods: A cohort of 662 patients with HF who were discharged alive after hospitalization were interviewed to evaluate symptoms of depression and were followed for 1 year. All-cause readmissions were documented by chart review. A marginal proportional rates model was used to model the effect of depression on the rate of rehospitalization with adjustment for known predictors of HF outcomes.

Results: Depression symptoms predicted multiple readmissions (adjusted hazard ratio [HR]: 1.08, 95% confidence interval [CI]: 1.03-1.13, P = 0.0008). Compared with patients without depression, those who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for major depression at index were at the highest risk for multiple rehospitalizations (HR: 1.51, 95% CI: 1.15-1.97, P = 0.003).

Conclusions: Depression is an independent risk factor for multiple all-cause readmissions in patients with HF.

MeSH terms

  • Adult
  • Aged
  • Depression / complications*
  • Depression / diagnosis
  • Depression / mortality
  • Depression / psychology
  • Female
  • Heart Failure / complications*
  • Heart Failure / diagnosis
  • Heart Failure / mortality
  • Heart Failure / psychology
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Readmission*
  • Prognosis
  • Proportional Hazards Models
  • Psychiatric Status Rating Scales
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Time Factors