Psychosocial and Physiological Predictors of Mortality in Patients of Heart Failure: Independent Effects of Marital Status and C-Reactive Protein
| Autor: | Yue Xu, Stacy Eisenberg, Biing Jiun Shen |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty 030204 cardiovascular system & hematology Logistic regression 03 medical and health sciences Social support 0302 clinical medicine Internal medicine medicine Humans Prospective Studies 030212 general & internal medicine Prospective cohort study Applied Psychology Depression (differential diagnoses) Aged Heart Failure Inflammation Univariate analysis Marital Status biology Depression C-reactive protein Social Support Middle Aged C-Reactive Protein biology.protein Marital status Female Psychology Psychosocial Clinical psychology |
| Zdroj: | International Journal of Behavioral Medicine. 24:83-91 |
| ISSN: | 1532-7558 1070-5503 |
| DOI: | 10.1007/s12529-016-9579-2 |
| Popis: | Few studies have examined the interplay between psychosocial and physiological variables in prediction of mortality in heart failure (HF) patients. This study investigated the prospective influence of marital status, social support, depression, and C-reactive protein (CRP) on the mortality of patients with chronic HF. In addition, it examined whether there was a mediating relationship between social support and marital status and whether depression and inflammation influenced one another to predict mortality of HF patients. The participants were 220 HF patients, among whom 48 were deceased over an average of 4.60 years. A number of psychosocial and biomedical variables were examined for their associations with mortality and their relationships between each other in hierarchical logistic regression analyses. After adjusting for New York Heart Association (NYHA) class, age, and gender, being unmarried predicted mortality (OR = 2.80, p = 0.004), whereas perceived social support did not. Higher CRP was not associated with depression, and it independently predicted mortality (OR = 1.92, p = 0.030). Depression predicted mortality only in the univariate analysis (OR = 1.02, p = 0.030), but the association was no longer significant either after removing somatic items or after adjusting for covariates. In the combined multivariate model, marital status (OR = 2.20, p = 0.047), CRP (OR = 1.91, p = 0.035), and NYHA class (OR = 2.41, p = 0.001) independently predicted mortality. Monitoring chronic HF patients who are unmarried, with elevated inflammation, or in higher NYHA class may help identify those at greater mortality risk to implement targeted intervention. |
| Databáze: | OpenAIRE |
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