Key result
High-risk social determinants are linked to ~5.3-fold higher 6-month hospitalization odds in female HF patients.
Why the study?
Knowledge gaps exist regarding how social determinants of health influence hospitalization rates in women with heart failure.
Does high-risk SDoH status increase the risk of hospitalization in women with heart failure?
Cohort (n=92)
No
Does high-risk SDoH status increase the risk of hospitalization in women with heart failure?
Odds Ratio: 5.31 (95% CI 1.59–17.73)
Absolute Event Rate: 33.3% vs 12.2%
p-value: p=0.0066
High-risk SDoH was associated with higher hospitalization odds in women with HF; hypothesis-generating and requires prospective validation before informing care.
Objective: The social determinants of health (SDoH) account for 80%-90% of modifiable contributors to health outcomes for chronic diseases such as heart failure. Knowledge gaps exist on how SDoH influences hospitalization rates in women with heart failure. Our aim was to evaluate the relationship between the baseline SDoH status of women with heart failure with subsequent all-cause and cardiovascular hospitalization. Methods: This is a prospective observational longitudinal cohort study of women diagnosed with heart failure with 6-month follow-up. The subjects completed SDoH assessment by the Institute of Medicine. Monthly follow-ups were performed to assess for hospitalization events. In total, 51 patients (55.4%) had overall high-risk SDoH (4 or more SDoH domains at risk). By the 6-month follow-up, 22 (23.9%) patients were hospitalized for any cause; 8 patients (8.7%) were hospitalized for cardiovascular causes. There were no deaths. In multivariate logistic regression analysis, the high-risk SDoH group had a higher odds ratio for all-cause hospitalization (OR 5.31, 95% CI 1.59-17.73). In addition, Kansas City Cardiomyopathy Questionnaire 12-item (KCCQ-12) scores, surrogate for quality of life, were worse in the high-risk SDoH group. Conclusion: SDoH adversely impacts hospitalizations and quality of life in women with heart failure. Future efforts for screening and interventions should evaluate the SDoH at all levels, including the individual health care provider, institutional, and national levels.
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Lee et al. (2023) conducted a cohort in Heart Failure (n=92). High-risk social determinants of health (≥4 at-risk domains) vs. Low-risk social determinants of health (<4 at-risk domains) was evaluated on All-cause hospitalization or death (OR 5.31, 95% CI 1.59-17.73, p=0.0066). High-risk social determinants of health (≥4 at-risk domains) significantly increased the odds of all-cause hospitalization at 6 months in women with heart failure (adjusted OR 5.31).
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