Psychosocial triggers for heart failure recurrence - a single-centre australian perspective

Abstract Aim To better define the psychosocial factors associated with heart failure recurrence. Method 100 randomly selected adult presentations to our hospital between July 1st 2021 and June 1st 2022, with a primary diagnosis of heart failure recurrence were studied. Organic and psychosocial factors were retrieved from patients’ electronic records. Outcomes of death at 1 year, length of stay, all-cause and heart failure specific hospital presentations were noted. Results Of all recurrence episodes, at least 27% were associated with psychosocial factors. Non-compliance was the most common (44%) followed by language barrier (35%), cognitive impairment (15%), social isolation (3%), healthcare access (2%), and apathy (1%). Episodes associated with only psychosocial factors had similar rates of death at 1 year (p=0.93), length of stay (p=0.24), heart failure specific (p=0.76) and all-cause (p=0.37) hospital presentations compared to those associated with organic factors. There was a significant increase in death at 1 year in those with concurrent organic and psychosocial factors compared to those with no identifiable factors (p=0.05). Conclusion At our hospital, non-adherence, language barriers, and cognitive impairment were the most common psychosocial factors associated with heart failure recurrence. There was no difference in outcomes between recurrences associated with psychosocial factors compared to those with only organic factors, highlighting their significant role in the management of heart failure. The increased risk of death at 1 year in those with concurrent organic and psychosocial factors offers an important prognostication tool to clinicians.Figure 1 Figure 2