Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure.

Published

Journal Article

BACKGROUND: Patients with congestive heart failure (CHF) may have a high prevalence of depression, which may increase the risk of adverse outcomes. OBJECTIVE: To determine the prevalence and relationship of depression to outcomes of patients hospitalized with CHF. METHODS: We screened patients aged 18 years or older having New York Heart Association class II or greater CHF, an ejection fraction of 35% or less, or both, admitted between March 1, 1997, and June 30, 1998, to the cardiology service of one hospital. Patients with a Beck Depression Inventory score of 10 or higher underwent a modified National Institute of Mental Health Diagnostic Interview Schedule to identify major depressive disorder. Primary care providers coordinated standard treatment for CHF and other medical and psychiatric disorders. We assessed all-cause mortality and readmission (rehospitalization) rates 3 months and 1 year after depression assessment. Logistic regression analyses were used to evaluate the independent prognostic value of depression after adjustment for clinical risk factors. RESULTS: Of 374 patients screened, 35.3% had a Beck Depression Inventory score of 10 or higher and 13.9% had major depressive disorder. Overall mortality was 7.9% at 3 months and 16.2% at 1 year. Major depression was associated with increased mortality at 3 months (odds ratio, 2.5 vs no depression; P =.08) and at 1 year (odds ratio, 2.23; P =.04) and readmission at 3 months (odds ratio, 1.90; P =.04) and at 1 year (odds ratio, 3.07; P =.005). These increased risks were independent of age, New York Heart Association class, baseline ejection fraction, and ischemic etiology of CHF. CONCLUSIONS: Major depression is common in patients hospitalized with CHF and is independently associated with a poor prognosis.

Full Text

Duke Authors

Cited Authors

  • Jiang, W; Alexander, J; Christopher, E; Kuchibhatla, M; Gaulden, LH; Cuffe, MS; Blazing, MA; Davenport, C; Califf, RM; Krishnan, RR; O'Connor, CM

Published Date

  • August 13, 2001

Published In

Volume / Issue

  • 161 / 15

Start / End Page

  • 1849 - 1856

PubMed ID

  • 11493126

Pubmed Central ID

  • 11493126

International Standard Serial Number (ISSN)

  • 0003-9926

Digital Object Identifier (DOI)

  • 10.1001/archinte.161.15.1849

Language

  • eng

Conference Location

  • United States