Differing Effects of Fatigue and Depression on Hospitalizations in Men and Women With Heart Failure.
Seongkum Heo, Jean McSweeney, Pao-Feng Tsai and 1 others
PMID 27802954WHAT IT FOUND
In heart failure patients, having both fatigue and depression was not associated with more hospitalizations than having either alone, though it was more than having neither.
Fatigue or depression alone was also more than neither; fatigue in men and women, depression only in women.
Key findings
01The both-symptoms group had more hospitalizations than the no-symptoms group but not more than the fatigue-only or depression-only groups.
02In additional analyses, the fatigue-only and depression-only groups each had more hospitalizations than the no-symptoms group in the total sample.
03Fatigue alone was associated with more hospitalizations than no symptoms in men and women, while depression alone was associated with more hospitalizations than no symptoms only in women.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most patients in the original database were excluded: 9287 of 9869 patients were removed for missing covariate data, and the 582 patients kept had more fatigue, depression, and hospitalizations than those excluded, so findings may not apply to patients with less fatigue, depression, or functional impairment. Fatigue and depression were identified from ICD-9 codes in medical records, not from symptom questionnaires, so they may not reflect patients' actual symptoms. Because depression was coded by ICD-9, the researchers could not separate cognitive-affective and somatic depression symptoms, so overlap with fatigue could not be examined. The analysis used existing records and did not test treatment, so it cannot establish that treating fatigue or depression would reduce hospitalizations.
Declared interests
The article is marked as supported by NIH extramural research. No author conflict-of-interest statement or commercial sponsor role is provided.
The easy way to misread this
Do not conclude that treating fatigue or depression will reduce heart failure hospitalizations. This was an observational record-based analysis, not a treatment trial, and the symptom diagnoses came from ICD codes that may not reflect patients' actual symptoms.