Association of psychosocial factors with all-cause hospitalizations in patients with atrial fibrillation.

Meyre, Pascal B; Springer, Anne; Aeschbacher, Stefanie; Blum, Steffen; Rodondi, Nicolas; Beer, Juerg H; Di Valentino, Marcello; Ammann, Peter; Blum, Manuel; Mathys, Rebecca; Meyer-Zürn, Christine; Bonati, Leo H; Sticherling, Christian; Schwenkglenks, Matthias; Kühne, Michael; Conen, David; Osswald, Stefan (2021). Association of psychosocial factors with all-cause hospitalizations in patients with atrial fibrillation. Clinical cardiology, 44(1), pp. 51-57. Wiley 10.1002/clc.23503

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BACKGROUND

A high burden of cardiovascular comorbidities puts patients with atrial fibrillation (AF) at high risk for hospitalizations, but the role of other factors is less clear.

HYPOTHESIS

To determine the relationship between psychosocial factors and the risk of unplanned hospitalizations in AF patients.

METHODS

Prospective observational cohort study of 2378 patients aged 65 or older with previously diagnosed AF across 14 centers in Switzerland. Marital status and education level were defined as social factors, depression and health perception were psychological components. The pre-defined outcome was unplanned all-cause hospitalization.

RESULTS

During a median follow-up of 2.0 years, a total of 1713 hospitalizations occurred in 37% of patients. Compared to patients who were married, adjusted rate ratios (aRR) for all-cause hospitalizations were 1.28 (95% confidence interval [CI], 0.97-1.69) for singles, 1.31 (95%CI, 1.06-1.62) for divorced patients, and 1.02 (95%CI, 0.82-1.25) for widowed patients. The aRRs for all-cause hospitalizations across increasing quartiles of health perception were 1.0 (highest health perception), 1.15 (95%CI, 0.84-1.59), 1.25 (95%CI, 1.03-1.53), and 1.66 (95%CI, 1.34-2.07). No different hospitalization rates were observed in patients with a secondary or primary or less education as compared to patients with a college degree (aRR, 1.06; 95%CI, 0.91-1.23 and 1.05; 95%CI, 0.83-1.33, respectively). Presence of depression was not associated with higher hospitalization rates (aRR, 0.94; 95%CI, 0.68-1.29).

CONCLUSIONS

The findings suggest that psychosocial factors, including marital status and health perception, are strongly associated with the occurrence of hospitalizations in AF patients. Targeted psychosocial support interventions may help to avoid unnecessary hospitalizations.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier NCT02105844.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Rodondi, Nicolas and Blum, Manuel

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0160-9289

Publisher:

Wiley

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

17 Nov 2020 12:31

Last Modified:

13 Jan 2021 12:32

Publisher DOI:

10.1002/clc.23503

PubMed ID:

33169859

Uncontrolled Keywords:

atrial fibrillation health perception psychosocial factors unplanned hospitalization

BORIS DOI:

10.7892/boris.148220

URI:

https://boris.unibe.ch/id/eprint/148220

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