Abstract P379: Multimorbidity in Heart Failure: The Impact of Number and Type of Comorbid Conditions on Outcomes
Background: Multimorbidity is common in heart failure (HF); however the impact of the number and type of comorbid conditions on outcomes remains uncertain.
Methods: Olmsted County, MN residents with incident HF from 2000-2010 were identified. The prevalence of 16 chronic conditions defined by the US Department of Health and Human Services was obtained at the time of HF. The chronic conditions were classified into 3 groups: cardiovascular (CV), other physical and mental. Cox regression was used to determine associations of the number of each type of condition and each individual condition with death or hospitalizations within 30 days or 1 year.
Results: 1,382 incident HF patients (mean±SD age 75±14, 46% male) were identified. The mean number of conditions per patient was 2.6±1.5, 1.2±1.1 and 0.30±0.61 for CV, physical and mental conditions, respectively. After a mean follow-up of 4.4 years, 814 deaths occurred while 301 hospitalizations occurred within 30 days and 774 within 1 year. The number of physical conditions was associated with all three outcomes after adjustment for age, sex, ejection fraction, in- or outpatient status, and number of other conditions, whereas mental conditions were significantly associated with death and hospitalizations within 1 year and the number of CV conditions was only associated with hospitalizations within 1 year (Table). When all individual conditions were included in one model, independent predictors of death included chronic kidney disease (CKD), COPD, dementia, diabetes and substance abuse; while cancer and CKD predicted 30-day hospitalizations and cancer, CKD, COPD and schizophrenia predicted hospitalizations within 1 year.
Conclusions: CV conditions are the most common type of comorbid conditions among HF patients, however physical and mental conditions are more strongly associated with death, 30 day and 1 year hospitalizations. This underscores the impact of non-CV conditions on outcomes in HF and highlights the need for new interventions targeting patients with these conditions.
Author Disclosures: S.M. Manemann: None. A.M. Chamberlain: None. C.M. Boyd: None. Y. Gerber: None. S.M. Dunlay: None. S.A. Weston: None. R. Jiang: None. V.L. Roger: None.
- © 2015 by American Heart Association, Inc.