Relationship between comorbidity and health outcomes in patients with heart failure: a systematic review and meta-analysis
Abstract Background The prevalence of heart failure (HF) is expected to rise due to increased survivorship and life expectancy of patients with acute heart conditions. Patients with HF and other multiple comorbid conditions are likely to have poor health outcomes. This study aimed to assimilate the...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-023-03527-x |
| _version_ | 1797453926044270592 |
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| author | Kyoung Suk Lee Da-In Park Jihyang Lee Oonjee Oh Nayoung Kim Gyumi Nam |
| author_facet | Kyoung Suk Lee Da-In Park Jihyang Lee Oonjee Oh Nayoung Kim Gyumi Nam |
| author_sort | Kyoung Suk Lee |
| collection | DOAJ |
| description | Abstract Background The prevalence of heart failure (HF) is expected to rise due to increased survivorship and life expectancy of patients with acute heart conditions. Patients with HF and other multiple comorbid conditions are likely to have poor health outcomes. This study aimed to assimilate the current body of knowledge and to provide the pooled effect of HF patients’ comorbid conditions on health outcomes. Methods A systematic search was performed using MEDLINE, EMBASE and CINAHL databases. Observational studies evaluating the relationship between comorbid conditions and the health outcomes of HF were included. The pooled effect sizes of comorbidity on the identified health outcomes were calculated using a random effects model, and the heterogeneity was evaluated using I2 statistics. Results A total of 42 studies were included in this review, and a meta-analysis was performed using the results of 39 studies. In the pooled analysis, the presence of a comorbid condition showed a significant pooled effect size in relation to the prognostic health outcomes: all-cause mortality (HR 1.31; 95% CI 1.18, 1.45), all-cause readmission (HR 1.16; 95% CI 1.09, 1.23), HF-related readmission (HR 1.13; 95% CI 1.05, 1.23), and non-HF-related readmission (HR 1.17; 95% CI 1.07, 1.27). Also, comorbidity was significantly associated with health-related quality of life and self-care confidence. Furthermore, we identified a total of 32 comorbid conditions from included studies. From these, 16 individual conditions were included in the meta-analyses, and we identified 10 comorbid conditions to have negative effects on overall prognostic outcomes: DM (HR 1.16, 95% CI 1.11, 1.22), COPD (HR 1.31, 95% CI 1.23, 1.39), CKD (HR 1.18, 95% CI 1.14, 1.23, stroke (HR 1.25, 95% CI 1.17, 1.31), IHD (HR 1.17, 95% CI 1.11, 1.23), anemia (HR 1.42, 95% CI 1.14, 1.78), cancer (HR 1.17, 95% CI 1.04, 1.32), atrial fibrillation (HR 1.25, 95% CI 1.01, 1.54), dementia (HR 1.19, 95% CI 1.03, 1.36) and depression (HR 1.17, 95% CI 1.04, 1.31). Conclusions Comorbid conditions have significantly negative pooled effects on HF patient health outcomes, especially in regard to the prognostic health outcomes. Clinicians should carefully identify and manage these conditions when implementing HF interventions to improve prognostic outcomes. |
| first_indexed | 2024-03-09T15:29:55Z |
| format | Article |
| id | doaj.art-1c3e5e11ebd44a3b902cb6fa70051942 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-03-09T15:29:55Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-1c3e5e11ebd44a3b902cb6fa700519422023-11-26T12:17:08ZengBMCBMC Cardiovascular Disorders1471-22612023-10-0123111610.1186/s12872-023-03527-xRelationship between comorbidity and health outcomes in patients with heart failure: a systematic review and meta-analysisKyoung Suk Lee0Da-In Park1Jihyang Lee2Oonjee Oh3Nayoung Kim4Gyumi Nam5College of Nursing, The Research Institute of Nursing Science, Seoul National UniversityDepartment of Nursing, College of Life Science and Nano Technology, Hannam UniversityCollege of Nursing, The Research Institute of Nursing Science, Seoul National UniversityCollege of Nursing, The Research Institute of Nursing Science, Seoul National UniversityCollege of Nursing, The Research Institute of Nursing Science, Seoul National UniversitySeoul National University HospitalAbstract Background The prevalence of heart failure (HF) is expected to rise due to increased survivorship and life expectancy of patients with acute heart conditions. Patients with HF and other multiple comorbid conditions are likely to have poor health outcomes. This study aimed to assimilate the current body of knowledge and to provide the pooled effect of HF patients’ comorbid conditions on health outcomes. Methods A systematic search was performed using MEDLINE, EMBASE and CINAHL databases. Observational studies evaluating the relationship between comorbid conditions and the health outcomes of HF were included. The pooled effect sizes of comorbidity on the identified health outcomes were calculated using a random effects model, and the heterogeneity was evaluated using I2 statistics. Results A total of 42 studies were included in this review, and a meta-analysis was performed using the results of 39 studies. In the pooled analysis, the presence of a comorbid condition showed a significant pooled effect size in relation to the prognostic health outcomes: all-cause mortality (HR 1.31; 95% CI 1.18, 1.45), all-cause readmission (HR 1.16; 95% CI 1.09, 1.23), HF-related readmission (HR 1.13; 95% CI 1.05, 1.23), and non-HF-related readmission (HR 1.17; 95% CI 1.07, 1.27). Also, comorbidity was significantly associated with health-related quality of life and self-care confidence. Furthermore, we identified a total of 32 comorbid conditions from included studies. From these, 16 individual conditions were included in the meta-analyses, and we identified 10 comorbid conditions to have negative effects on overall prognostic outcomes: DM (HR 1.16, 95% CI 1.11, 1.22), COPD (HR 1.31, 95% CI 1.23, 1.39), CKD (HR 1.18, 95% CI 1.14, 1.23, stroke (HR 1.25, 95% CI 1.17, 1.31), IHD (HR 1.17, 95% CI 1.11, 1.23), anemia (HR 1.42, 95% CI 1.14, 1.78), cancer (HR 1.17, 95% CI 1.04, 1.32), atrial fibrillation (HR 1.25, 95% CI 1.01, 1.54), dementia (HR 1.19, 95% CI 1.03, 1.36) and depression (HR 1.17, 95% CI 1.04, 1.31). Conclusions Comorbid conditions have significantly negative pooled effects on HF patient health outcomes, especially in regard to the prognostic health outcomes. Clinicians should carefully identify and manage these conditions when implementing HF interventions to improve prognostic outcomes.https://doi.org/10.1186/s12872-023-03527-xHeart failureComorbidityMultimorbidityObservational studySystematic reviewMeta-analysis |
| spellingShingle | Kyoung Suk Lee Da-In Park Jihyang Lee Oonjee Oh Nayoung Kim Gyumi Nam Relationship between comorbidity and health outcomes in patients with heart failure: a systematic review and meta-analysis BMC Cardiovascular Disorders Heart failure Comorbidity Multimorbidity Observational study Systematic review Meta-analysis |
| title | Relationship between comorbidity and health outcomes in patients with heart failure: a systematic review and meta-analysis |
| title_full | Relationship between comorbidity and health outcomes in patients with heart failure: a systematic review and meta-analysis |
| title_fullStr | Relationship between comorbidity and health outcomes in patients with heart failure: a systematic review and meta-analysis |
| title_full_unstemmed | Relationship between comorbidity and health outcomes in patients with heart failure: a systematic review and meta-analysis |
| title_short | Relationship between comorbidity and health outcomes in patients with heart failure: a systematic review and meta-analysis |
| title_sort | relationship between comorbidity and health outcomes in patients with heart failure a systematic review and meta analysis |
| topic | Heart failure Comorbidity Multimorbidity Observational study Systematic review Meta-analysis |
| url | https://doi.org/10.1186/s12872-023-03527-x |
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