Factors Associated With All-Cause Rehospitalization and Mortality in Patients with Heart Failure

Abstract

Abstract Background and Significance: Heart failure is diagnosed in over 5.7 million Americans. Despite substantial scientific advancements in the field of heart failure management this disease continues to be a primary cause of death in 50,000 patients and noted in the death findings of an additional 250,000 individuals annually. Over 6.5 million hospital days and over 668,000 emergency room visits. Depression is prevalent in over 20% of HF patients and in 45% of HF patients following an acute exacerbation of their disease. Purposes: To explore the effect of reactive depression on all-cause rehospitalization and all-cause mortality in NYHA Class III and IV patients during the 12 month following an index hospitalization for HF exacerbation. The study aims were: (a) describe the effect of depression, (b) explain the variance of depression, and (c) determine the moderator effect of depression on patient preparedness to manage complex HF home care all-cause rehospitalization and/or all-cause mortality in HF patients. Theoretical Framework: The Chronic Care Management Theory will guide the study. Methods: Secondary Data Analysis of data obtained from the longitudinal NIH funded SMAC-HF trial. Data Analysis: Descriptive statistics, logistic regression, and multiple linear regression analyses with and with/out interaction effects were performed to address the study purpose and aims. Findings: Descriptive statistics, logistic regression, and multiple linear regression analyses with and with/out interaction effects were performed to address the study purpose and aims. Discussion/Conclusion: Depression as measured by CES-D score greater than 16 has a significant relationship with all-cause rehospitalization p=.09 and all-cause rehospitalization and mortality p=.09. In this study, depression did not demonstrate a relationship with mortality alone. In addition, depression did not have an interaction effect between preparedness and all-cause rehospitalization and/or mortality. Screening for depression should be part of heart failure management. Management of depression may decrease rehospitalization in HF patients.