Department of Cardiology, Hospital Clínico Universitario de Valencia, University of Valencia, INCLIVA, Avda. Blasco Ibáñez 17, 46010, Valencia, Spain.
CIBER Cardiovascular, Madrid, Spain.
Sci Rep. 2024 Sep 27;14(1):22229. doi: 10.1038/s41598-024-72847-5.
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.
心力衰竭（HF）与较高的孤独感发生率相关。本研究旨在评估HF 患者的孤独感是否与不良临床终点相关。此外，我们还旨在研究 HF 患者孤独感的相关危险因素。我们纳入了 298 名诊断为稳定 HF 的患者。评估了临床、生化、超声心动图参数和 ESTE II 量表的孤独感。我们通过 Cox（死亡或任何住院）和负二项回归（再次住院或急诊就诊）分析了暴露与不良临床终点之间的关联。使用逻辑回归分析与孤独感相关的危险因素。患者的平均年龄为 75.8±9.4 岁，111 名（37.2%）为女性，53 名（17.8%）丧偶，154 名（51.7%）患者射血分数保留。ESTE II 评分的中位数（p25-p75%）为 9.0（6.0-12.0），36.9%的患者符合孤独感标准（>10）。女性（OR=2.09；95%CI 1.11-3.98，p=0.023）和丧偶（OR=3.25；95%CI 1.51-7.01，p=0.003）与更高的孤独感风险相关。在中位随访 362 天（323-384）期间，93 名患者（31.3%）出现死亡或全因入院的复合事件。孤独感与复合终点时死亡或任何再入院的时间风险显著相关（HR=1.83；95%CI 1.18-2.84，p=0.007）。女性和丧偶是 HF 患者孤独感的危险因素。孤独感与随访期间更高的发病率相关。
