Treating Depression, Fatigue in Heart Failure Patients Tied to Shorter Hospital Stay

Treating fatigue and depression in patients with heart failure may ultimately lead to fewer hospital stays, according to a new study published in the American Journal of Critical Care (AJCC).

Researchers from the University of Arkansas for Medical Sciences (UAMS), Little Rock investigated the complex relationship between fatigue, depression and gender in patients with heart failure and the effect on hospitalization.

“Our research provides a good picture of the relationships of fatigue and depression to all-cause hospitalizations of heart failure patients,” said co-author Seongkum Heo, R.N., Ph.D., associate professor at the UAMS College of Nursing.

“Fatigue needs to be addressed in patients with heart failure, and depression needs to be managed, especially in women. Doing so could help reduce hospitalizations, improve outcomes and lower costs.”

For the study, researchers reviewed the data of 9,869 patients who had been hospitalized for any reason at UAMS with a diagnosis of heart failure during a three-year period from the beginning of 2010 to the end of 2012.

They compared the effects of fatigue and depression on hospitalization in four groups of patients: fatigue-only, depression-only, both depression and fatigue, and those without fatigue or depression.

All study variables — hospitalizations, demographic characteristics, vital signs, comorbid conditions, results of laboratory tests, clinical characteristics, and medications — were present in the records of 582 patients, allowing for further analysis related to fatigue and depression.

In the total sample and gender-specific subgroups, patients with both fatigue and depression were hospitalized more often than those without either condition. They also had more visits to the emergency department and longer lengths of stay.

Specifically, about 44 percent of the sample did not experience fatigue and depression; 29.7 percent had fatigue only; 10.7 percent had depression only; and 15.6 percent had both fatigue and depression. Therefore, 45.3 percent had a diagnosis of fatigue, and 26.3 percent had a diagnosis of depression.

A diagnosis of fatigue was significantly tied to a greater number of all-cause hospitalizations in both men and women. A diagnosis of depression was significantly linked to a greater number of all-cause hospitalizations in women only.

Female patients with either depression or fatigue and male patients with fatigue-only had more hospitalizations than those without either condition.

The both-symptoms group was older and had lower heart rates, lower diastolic blood pressure and higher left ventricular ejection fraction than all other groups.

Source: American Association of Critical Care Nurses