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Minerva Cardioangiologica 2020 Sep 30

DOI: 10.23736/S0026-4725.20.05346-3


language: English

Depression is associated with an increased risk of readmission in patients with heart failure: a systematic review and meta-analysis

Jakrin KEWCHAROEN 1 , Chol TACHORUEANGWIWAT 1, Chanavuth KANITSORAPHAN 1, Sakditad SAOWAPA 2, Nattapat NITINAI 3, Wasawat VUTTHIKRAIVIT 4, Pattara RATTANAWONG 2, 5, Dipanjan BANERJEE 6, 7

1 University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA; 2 Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 3 Faculty of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand; 4 Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA; 5 Cardiovascular Medicine, Mayo Clinic, Scottsdale, AZ, USA; 6 Queens Heart Physician Practice, Queen’s Medical Center, Honolulu, HI, USA; 7 University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA


BACKGROUND: Heart failure (HF) is one of the world leading causes of admission and readmission. Recent studies have shown that the presence of depression is associated with hospital readmission in patients after an index admission for heart failure (HF). However, there is disagreement between published studies regarding this finding. We performed a systematic review and meta-analysis to evaluate the effect of depression on readmission rates in HF patients.
METHODS: We searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were published study evaluating readmission rate of HF patients, with and without depression. Data from each study were combined using a random-effects model, generic inverse variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals.
RESULTS: Ten studies were included in the meta-analysis with a total of 53,165 patients (6,194 patients with depression). The presence of depression was associated with an increased risk of readmission in patients with HF (pooled HR=1.54, 95%CI=1.22-1.94, pvalue<0.001, I2=55.4%). In a subgroup analysis, depression was associated with an increased risk of readmission in patients with HF in both short-term (≤ 90 days) followup (pooled HR=1.75, 95%CI=1.07-2.85, p-value=0.025, I2=76.0%) and long-term (> 90 days) follow-up (pooled HR=1.58, 95% CI =1.32-1.90, p-value<0.001, I2=0.0%).
CONCLUSIONS: Our meta-analysis demonstrated that depression is associated with an increased risk of hospital readmission in patients with HF.

KEY WORDS: Heart Failure; Depression; Readmission

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