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Perceived Social Isolation and Outcomes in Patients With Heart Failure
BACKGROUND: Perceived social isolation has been shown to have a negative impact on health outcomes, particularly among older adults. However, these relationships have not been fully examined among patients with heart failure. METHODS AND RESULTS: Residents from 11 southeast Minnesota counties with a...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015354/ https://www.ncbi.nlm.nih.gov/pubmed/29794038 http://dx.doi.org/10.1161/JAHA.117.008069 |
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author | Manemann, Sheila M. Chamberlain, Alanna M. Roger, Véronique L. Griffin, Joan M. Boyd, Cynthia M. Cudjoe, Thomas K. M. Jensen, Daniel Weston, Susan A. Fabbri, Matteo Jiang, Ruoxiang Finney Rutten, Lila J. |
author_facet | Manemann, Sheila M. Chamberlain, Alanna M. Roger, Véronique L. Griffin, Joan M. Boyd, Cynthia M. Cudjoe, Thomas K. M. Jensen, Daniel Weston, Susan A. Fabbri, Matteo Jiang, Ruoxiang Finney Rutten, Lila J. |
author_sort | Manemann, Sheila M. |
collection | PubMed |
description | BACKGROUND: Perceived social isolation has been shown to have a negative impact on health outcomes, particularly among older adults. However, these relationships have not been fully examined among patients with heart failure. METHODS AND RESULTS: Residents from 11 southeast Minnesota counties with a first‐ever International Classification of Diseases, Ninth Revision (ICD‐9) code 428 for heart failure between January 1, 2013, and March 31, 2015 (N=3867), were prospectively surveyed to measure perceived social isolation. A total of 2003 patients returned the survey (response rate, 52%); 1681 patients completed all questions and were retained for analysis. Among these patients (53% men; mean age, 73 years), ≈19% (n=312) had moderate perceived social isolation and 6% (n=108) had high perceived social isolation. After adjustment, patients reporting moderate perceived social isolation did not have an increased risk of death, hospitalizations, or emergency department visits compared with patients reporting low perceived social isolation; however, patients reporting high perceived social isolation had >3.5 times increased risk of death (hazard ratio, 3.74; 95% confidence interval [CI], 1.82–7.70), 68% increased risk of hospitalization (hazard ratio, 1.68; 95% CI, 1.18–2.39), and 57% increased risk of emergency department visits (hazard ratio, 1.57; 95% CI, 1.09–2.27). Compared with patients who self‐reported low perceived social isolation, patients reporting moderate perceived social isolation had a 16% increased risk of outpatient visits (rate ratio, 1.16; 95% CI, 1.03–1.31), whereas those reporting high perceived social isolation had a 26% increased risk (rate ratio, 1.26; 95% CI, 1.04–1.53). CONCLUSIONS: In patients with heart failure, greater perceived social isolation is associated with an increased risk of death and healthcare use. Assessing perceived social isolation during the clinical encounter with a brief screening tool may help identify patients with heart failure at greater risk of poor outcomes. |
format | Online Article Text |
id | pubmed-6015354 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-60153542018-07-05 Perceived Social Isolation and Outcomes in Patients With Heart Failure Manemann, Sheila M. Chamberlain, Alanna M. Roger, Véronique L. Griffin, Joan M. Boyd, Cynthia M. Cudjoe, Thomas K. M. Jensen, Daniel Weston, Susan A. Fabbri, Matteo Jiang, Ruoxiang Finney Rutten, Lila J. J Am Heart Assoc Original Research BACKGROUND: Perceived social isolation has been shown to have a negative impact on health outcomes, particularly among older adults. However, these relationships have not been fully examined among patients with heart failure. METHODS AND RESULTS: Residents from 11 southeast Minnesota counties with a first‐ever International Classification of Diseases, Ninth Revision (ICD‐9) code 428 for heart failure between January 1, 2013, and March 31, 2015 (N=3867), were prospectively surveyed to measure perceived social isolation. A total of 2003 patients returned the survey (response rate, 52%); 1681 patients completed all questions and were retained for analysis. Among these patients (53% men; mean age, 73 years), ≈19% (n=312) had moderate perceived social isolation and 6% (n=108) had high perceived social isolation. After adjustment, patients reporting moderate perceived social isolation did not have an increased risk of death, hospitalizations, or emergency department visits compared with patients reporting low perceived social isolation; however, patients reporting high perceived social isolation had >3.5 times increased risk of death (hazard ratio, 3.74; 95% confidence interval [CI], 1.82–7.70), 68% increased risk of hospitalization (hazard ratio, 1.68; 95% CI, 1.18–2.39), and 57% increased risk of emergency department visits (hazard ratio, 1.57; 95% CI, 1.09–2.27). Compared with patients who self‐reported low perceived social isolation, patients reporting moderate perceived social isolation had a 16% increased risk of outpatient visits (rate ratio, 1.16; 95% CI, 1.03–1.31), whereas those reporting high perceived social isolation had a 26% increased risk (rate ratio, 1.26; 95% CI, 1.04–1.53). CONCLUSIONS: In patients with heart failure, greater perceived social isolation is associated with an increased risk of death and healthcare use. Assessing perceived social isolation during the clinical encounter with a brief screening tool may help identify patients with heart failure at greater risk of poor outcomes. John Wiley and Sons Inc. 2018-05-23 /pmc/articles/PMC6015354/ /pubmed/29794038 http://dx.doi.org/10.1161/JAHA.117.008069 Text en © 2018 The Authors, Mayo Clinic and Olmsted County Public Health Services. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Manemann, Sheila M. Chamberlain, Alanna M. Roger, Véronique L. Griffin, Joan M. Boyd, Cynthia M. Cudjoe, Thomas K. M. Jensen, Daniel Weston, Susan A. Fabbri, Matteo Jiang, Ruoxiang Finney Rutten, Lila J. Perceived Social Isolation and Outcomes in Patients With Heart Failure |
title | Perceived Social Isolation and Outcomes in Patients With Heart Failure |
title_full | Perceived Social Isolation and Outcomes in Patients With Heart Failure |
title_fullStr | Perceived Social Isolation and Outcomes in Patients With Heart Failure |
title_full_unstemmed | Perceived Social Isolation and Outcomes in Patients With Heart Failure |
title_short | Perceived Social Isolation and Outcomes in Patients With Heart Failure |
title_sort | perceived social isolation and outcomes in patients with heart failure |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015354/ https://www.ncbi.nlm.nih.gov/pubmed/29794038 http://dx.doi.org/10.1161/JAHA.117.008069 |
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