Major depressive disorder (MDD) was associated with decreased 30-day mortality among patients with heart failure with reduced ejection fraction (HFrEF) or HF with preserved EF (HFpEF). These findings were published in Cureus.
Data from the Nationwide Readmissions Database collected in 2018 across 28 states in the US were analyzed by researchers. Patients (N=99,817) with HFrEF (n=66,403) or HFpEF (n=33,414) were assessed for MDD comorbidity, 30-day mortality, and readmission.
Comorbid MDD was observed among 10% of the HFrEF and 13.9% of the HFpEF patient cohorts. Patients in the MDD cohorts were significantly younger (both P <.01) and more likely to be female (both P <.01).
The composite outcome of 30-day mortality and hospital readmission was not significantly associated with MDD among patients in the HFrEF (adjusted odds ratio [aOR], 0.94; 95% CI, 0.85-1.04; P =.27) or HFpEF (aOR, 0.93; 95% CI, 0.81-1.07; P =.32) cohorts.
The 30-day all-cause hospital readmission was not associated with MDD among the patients with HFrEF (aOR, 0.94; 95% CI, 0.85-1.05; P =.27) or HFpEF (aOR, 0.93; 95% CI, 0.81-1.07; P =.32), but 30-day mortality was significantly reduced among patients with comorbid MDD and HFrEF (aOR, 0.79; 95% CI, 0.62-1.00; P =.05) or HFpEF (aOR, 0.69; 95% CI, 0.50-0.95; P =.02).
Among the HFrEF cohort, patients with and without MDD were associated with higher health care costs during their initial admission ($69,810 vs $62,935; P =.03) but not during readmission ($74,591 vs $66,230; P =.10). Among the patients in the HFpEF group, no significant difference in health care costs were observed.
Depression was associated with increased hospital stays among both the HFrEF (6.6±8.9 vs 5.7±7.6 days; P <.01) and HFpEF (5.6±5.5 vs 5.3±5.5 days; P <.01) patient cohorts.
This study was limited by a lack of access to information about treatments and medications used.
The study authors concluded patients with HF and comorbid MDD were not at increased risk for 30-day readmission or mortality. Depression was associated with decreased 30-day mortality but increased health care utilization.
Thyagaturu HS, Thangjui S, Shah K, Naik RV, Bondi G. Association of major depressive disorder on heart failure with reduced and preserved ejection fraction: analysis of national readmission database 2018. Cureus. 2021;13(5):e15107. doi:10.7759/cureus.15107