Key result
Unwanted loneliness is linked to ~83% higher risk of death or hospitalization in HF patients.
Why the study?
Heart failure is associated with a high prevalence of unwanted loneliness, but its association with adverse clinical endpoints and its specific risk factors in this population required evaluation.
Does unwanted loneliness increase the risk of death or hospitalization in patients with stable heart failure?
Cohort (n=298)
Single-blind
No
Does unwanted loneliness increase the risk of death or hospitalization in patients with stable heart failure?
Hazard Ratio: 1.83 (95% CI 1.18–2.84)
Absolute Event Rate: 5.1% vs 3.3%
p-value: p=0.007
Unwanted loneliness is highly prevalent in heart failure patients, particularly among women and widows, and is independently associated with an increased risk of death or all-cause hospitalization.
Loneliness was associated with higher death or admission risk in stable HF; hypothesis-generating for interventions, requiring prospective confirmation before practice change.
Heart failure (HF) is associated with a high prevalence of unwanted loneliness. This study aimed to assess whether unwanted loneliness was associated with adverse clinical endpoints in HF patients. Additionally, we also aimed to examine the risk factors associated with unwanted loneliness in HF. We included 298 patients diagnosed with stable HF. Clinical, biochemical, echocardiographic parameters and loneliness using ESTE II scale were assessed. We analyzed the association between the exposure and adverse clinical endpoints by Cox (death or any hospitalization), and negative binomial regressions (recurrent hospitalizations or visits to the emergency room). Risk factors associated with loneliness were analyzed using logistic regression. The mean age was 75.8 ± 9.4 years, with 111 (37.2%) being women, 53 (17.8%) widowed, and 154 (51.7%) patients having preserved ejection fraction. The median (p25-p75%) ESTE II score was 9.0 (6.0-12.0), and 36.9% fulfilled the loneliness criteria (> 10). Both women (OR = 2.09; 95% CI 1.11-3.98, p = 0.023) and widowhood (OR = 3.25; 95% CI 1.51-7.01, p = 0.003) were associated with a higher risk of loneliness. During a median follow-up of follow-up of 362 days (323-384), 93 patients (31.3%) presented the combined episode of death or all-cause admissions. Loneliness was significantly related to the risk of time to the composite of death or any readmission during the composite (HR = 1.83; 95% CI 1.18-2.84, p = 0.007). Women and widowhood emerge as risk factors for unwanted loneliness in HF patients. Unwanted loneliness is associated with higher morbidity during follow-up.
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Benito et al. (2024) conducted a cohort in Heart failure (n=298). Unwanted loneliness vs. No unwanted loneliness was evaluated on Composite of time to death or hospital admission for all causes (HR 1.83, 95% CI 1.18-2.84, p=0.007). Unwanted loneliness significantly increased the risk of the composite of death or any-cause hospital admission (HR 1.83) in patients with heart failure.
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