The following is a summary of “Relationship between comorbidity and health outcomes in patients with heart failure: a systematic review and meta-analysis,” published in the October 2023 issue of Cardiology by Lee et al.
Heart failure (HF) prevalence is rising due to increased survivorship, and patients with HF and multiple comorbidities have poor health outcomes. Researchers started a retrospective study to assess the pooled effect of HF patients’ comorbid conditions on health outcomes.
They conducted a systematic search using MEDLINE, EMBASE, and CINAHL databases. Observational studies on comorbid conditions and HF health outcomes were included. Pooled effect sizes of comorbidity on health outcomes were calculated, and heterogeneity was assessed (I2 statistic).
The results showed 42 studies and a meta-analysis of 39 studies. Comorbid conditions had a significant effect on prognostic health outcomes, including all-cause mortality (1.31 HR; 95% CI 1.18, 1.45), all-cause readmission (1.16 HR; 95% CI 1.09, 1.23), HF-related readmission (1.13 HR; 95% CI 1.05, 1.23), and non-HF-related readmission (1.17 HR; 95% CI 1.07, 1.27). Comorbidity was also related to health-related quality of life and self-care confidence. Additionally, 32 comorbid conditions were identified, with 16 of them affecting overall prognostic outcomes negatively: DM (1.16 HR, 95% CI 1.11, 1.22), COPD (1.31 HR, 95% CI 1.23, 1.39), CKD (1.18 HR, 95% CI 1.14, 1.23), stroke (1.25 HR, 95% CI 1.17, 1.31), IHD (1.17 HR, 95% CI 1.11, 1.23), anemia (1.42 HR, 95% CI 1.14, 1.78), cancer (1.17 HR, 95% CI 1.04, 1.32), atrial fibrillation (1.25 HR, 95% CI 1.01, 1.54), dementia (1.19 HR, 95% CI 1.03, 1.36), and depression (1.17 HR, 95% CI 1.04, 1.31).
They concluded that comorbidities worsen HF prognosis, so clinicians should identify and manage them carefully.
Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-023-03527-x
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