Social isolation is associated with 90-day rehospitalization due to heart failure

2018 ◽  
Vol 18 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Hiroshi Saito ◽  
Nobuyuki Kagiyama ◽  
Noriko Nagano ◽  
Kozue Matsumoto ◽  
Kenji Yoshioka ◽  
...  

Background: Social isolation has been reported to be associated with decreased quality of life and the onset of organic diseases. The objective of this study was to investigate the prevalence of social isolation in patients with heart failure and whether it is associated with rehospitalization. Methods and results: The study included consecutive patients aged ⩾55 years who were hospitalized due to heart failure. Social isolation was assessed using total scores less than 12 on an abbreviated version of the Lubben Social Network Scale. The endpoint was heart failure rehospitalization within 90 days after discharge. Among 148 patients with heart failure (80±8 years old, 51% male), 73 (49%) were socially isolated. The patients with social isolation had similar comorbidities compared with those without social isolation. Heart failure rehospitalization occurred within 90 days for 25 patients and the heart failure rehospitalization rate was significantly higher in the social isolation group ( p=0.036). LASSO (least absolute shrinkage and selection operator) regression confirmed that social isolation was one of the strongest predictors of heart failure rehospitalization, showing larger effects than living alone, being unemployed, and other established risk factors. Conclusion: Half of the patients with heart failure reported social isolation, which had a strong association with heart failure rehospitalization.

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Ikeda ◽  
K Iwatsu ◽  
K Matsumura ◽  
H Ashikawa ◽  
K Takabayashi ◽  
...  

Abstract Background Perceived social isolation (SI), the subjective sense of feelings of loneliness or isolation, has a negative impact on health outcomes, particularly in older adults. Although SI may also contribute to poor prognosis in patients with HF, evidence on the relationship between SI and outcomes in patients with HF is limited. Purpose The aim of this study was to investigate the relationship between SI and hospital readmission in patients with HF. Methods This study was a single center prospective cohort study. We consecutively enrolled 203 patients (mean age 72.9±11.7) who admitted for acute HF or exacerbation of chronic HF. At hospital discharge, we assessed perceived SI by using Lubben Social Network Scale - 6 (LSNS-6). Lower scores in LSNS-6 represents greater SI. Study outcome was rehospitalization for worsening HF within 180 days after discharge. We selected the optimal cutoff point of LSNS-6 that predict a worse outcome by the receiver operating characteristic (ROC) curve analysis. We investigate the association between SI and 180-days HF rehospitalization by using Cox proportional-hazard models, controlling for potential confounding factors. Results During follow up, A total of 40events (19.7%) were observed. The optimal cut-off point of LSNS-6 score was 17 points (the area under the ROC curve: 0.62, p<0.05, sensitivity: 82.5%, specificity 42.4%). Kaplan-Meier survival curves showed that those patients with greater SI (LSNS-6≤17) presented significantly higher HF rehospitalization rate (Figure). After adjusting for several pre-existing prognostic factors, LSNS-6≤17 was independently associated with HF rehospitalization (hazard ratio2.15,95% confidence interval 1.00–4.89). Conclusion The present study shows that SI is a independent predictor of HF rehospitalization in patients with HF. Assessing SI in the clinical practice with a brief screening tool may help identify patients with heart failure at greater risk of rehospitalization.


REGION ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 83-97
Author(s):  
Lise Bourdeau Lepage ◽  
Balázs Kotosz

In response to the Covid‑19 health crisis, the French government has imposed various measures, referred to as social-distancing measures, including a lockdown with the primary objective of reducing face-to-face interactions between people in order to limit the spread of the virus. This paper seeks to determine if the social-distancing measures and lockdown lead to social isolation for certain people and have an impact on French people’s well-being. First, it reveals that the feelings of social isolation have substantially increased in France during this lockdown.  Second, it explores the factors that help to explain these changes by developing a predictive model and reveals that living alone, being a woman, being young are factors that explain this increase in felling of social isolation. Third, the estimation of the effects of changes in feelings of social isolation on changes in the reported level of well-being of French respondents during lockdown shows that people who reported feeling more socially isolated than others has the lowest levels of well-being among the French population; and that the increase in people’s feelings of social isolation during lockdown is a factor that has a negative impact on their level of well-being.


2011 ◽  
Vol 7 (1) ◽  
pp. 66 ◽  
Author(s):  
Ewa Piotrowicz ◽  
Ryszard Piotrowicz ◽  
◽  

Exercise training (ET) is now recommended as an important component of a comprehensive approach to patients with heart failure (HF). Despite the existence of proven benefits of ET, many HF patients remain physically inactive. Introducing telerehabilitation (TR) may eliminate most of the factors that result in the currently low number of patients undergoing outpatient-based rehabilitation programmes and thus increase the percentage of those who will undergo cardiac rehabilitation. Despite the fact that TR is highly applicable and effective, there are few papers dedicated to the study of TR in HF patients. Until recently, only a couple of home rehabilitation-monitoring models have been presented, from the simplest, i.e. heart rate monitoring and transtelephonic electrocardiographic monitoring, through to the more advanced tele-electocardiogram (tele-ECG) monitoring (via a remote device) and realtime electrocardiographic and voice transtelephonic monitoring. It seems the last two are the most useful and reliable. Based on published studies, TR in HF patients could be equally effective as and provide similar improvements in health-related quality of life to standard outpatient cardiac rehabilitation. In addition, adherence to cardiac rehabilitation seems to be better during TR. Due to disease-related limitations, TR seems to be a viable alternative for comprehensive cardiac rehabilitation in HF patients. Further studies are needed to confirm the utility of this type of rehabilitation in routine clinical practice, including its cost-effectiveness. Because of the diversity of technological systems, it is necessary to create a platform to ensure compatibility between the devices used in telemedicine.


2016 ◽  
Vol 9 (4) ◽  
pp. 878-883 ◽  
Author(s):  
Mahshid Borumandpour Gholamabbas Valizadeh ◽  
Alizallah Dehghan ◽  
Alireza Poumarjani ◽  
Maryam Ahmadifar

2021 ◽  
Vol 11 (2) ◽  
pp. 418-429
Author(s):  
Joana Pereira Sousa ◽  
Hugo Neves ◽  
Miguel Pais-Vieira

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognition of symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate the longitudinal effect of a nursing-led complex intervention on self-care management and quality-of-life changes in patients with heart failure and assessed by a pilot study performed on sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p < 0.001) and emergency admission (IRR 4.24; p < 0.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assignment_group = −0.881; p < 0.001) and in the quality of life (βSlope. Assignment_group = 1.739; p < 0.001). This study supports that a nurse-led programme on symptom recognition and fluid restriction can positively impact self-care behaviours and quality of life in patients with heart failure. This randomised controlled trial was retrospectively registered (NCT04892004).


2011 ◽  
Vol 17 (9) ◽  
pp. 755-763 ◽  
Author(s):  
Rebecca L. Dekker ◽  
Terry A. Lennie ◽  
Nancy M. Albert ◽  
Mary K. Rayens ◽  
Misook L. Chung ◽  
...  

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