Mental state influences re-admission after cardiac treatment

Heart failure patients' mental health history and their thinking abilities may influence whether they're re-admitted to the hospital within a month of discharge, a new study says.

Depression, a history of substance abuse and a history of coronary artery disease were linked with patients' hospital admissions during the previous year, the researchers found.

Factors associated with re-admission within 30 days of discharge included memory problems, a history of mental health treatment and/or the use of an antidepressant.

The severity of congestive heart failure was not a factor in either admission or re-admission rates, according to the study, which was published online in the journal Psychosomatics.

"Our results agree with several recent studies in finding an adverse impact of depression on admission and re-admission rates," lead author Mark Ketterer, a psychologist at Henry Ford Health System in Detroit, said in a news release.

"In addition, substance abuse and chronic kidney disease may also adversely impact these rates in congestive heart failure patients."

Behaviour

The study involved 84 patients, average age 66, admitted to the Henry Ford Hospital in Detroit for treatment of acute congestive heart failure.

"Even severe heart disease, except in the extreme, appears to be manageable after release from the hospital unless it's complicated by one or more of the behavioural factors," said Ketterer.

Perhaps the most important finding is the link between emotional stress and/or cognitive impairment and early re-admission to the hospital, said Ketterer.

"Both suggest a possible way to predict re-admission and avoid it," he said.

Educating patients about their mental illness, and getting live-in family members to help patients follow their medication regimen and keep medical appointments may also help reduce hospital re-admissions, the researchers concluded.

"Given both the exorbitant fiscal costs and known health risks of hospitalisation, including exposure to drug-resistant infections and medical errors, it could be well worth further study to test our findings," Ketterer said.

More information

The US National Heart, Lung, and Blood Institute has more about heart failure.

Picture:  Hospital bed from Shutterstock