Living with Family and Clinical, Demographic, and Laboratory Characteristics in Patients with Heart Failure

Year 2024, Volume: 46 Issue: 1, 35 - 40, 29.03.2024

Emine Tuğçe Şahin Gülsüm Meral Yılmaz Öztekin Ahmet Genç Anıl Şahin

https://doi.org/10.7197/cmj.1414749

Abstract

Objective: Heart failure (HF) is a progressive clinical syndrome associated with significant morbidity and mortality. It is known that during the course of this syndrome, social factors can impact clinical outcomes alongside medical interventions. Studies have demonstrated that social support provides favorable developments in mortality rates, event-free survival, and readmission rates in HF patients. In our study, we aimed to elucidate the effects of the concept of family, the most significant social support, on clinical characteristics, exercise capacity, echocardiographic, and laboratory features in HF cases. Methods: A multicenter cohort study was conducted, including 303 patients previously diagnosed with HF, following current guidelines and presenting for outpatient follow-up. Patients with a new diagnosis of HF, those with acute decompensated HF, and those with a history of malignancy were excluded from the study. Demographic data (age, gender), comorbidities (hypertension, diabetes mellitus, atrial fibrillation, etc.), HF treatments, laboratory tests, and detailed transthoracic echocardiography results were recorded. Results: Patients were divided into two groups based on whether they lived with a spouse, parent, child, or without any of them, defining the presence or absence of family support. In the study, 303 patients with an average age of 62.1±13.0, of which 94 (31%) were female, were included. The mean left ventricular ejection fraction was 28.7±8.1. When the groups were compared in terms of comorbidities, there was no statistically significant difference in the presence of hypertension, diabetes mellitus, hyperlipidemia, chronic obstructive pulmonary disease, stroke, or atrial fibrillation (all p>0.005). Coronary artery disease was more frequently observed in the group with family support, while chronic kidney disease was more common in the group without family support (p=0.008 and p=0.012, respectively). Smoking prevalence was significantly higher in the group without family support, while alcohol use showed no significant difference (p=0.046 and p=0.602, respectively). Analyzing the results, it was observed that patients with family support were more regularly monitored for HF reasons (71% vs. 59%, p=0.054). Conclusion: It has been observed that the social support provided by family members in individuals with HF can have positive effects on the clinical course of the disease and the patient's lifestyle.

Keywords

heart failure, social support, family

Kalp Yetersizliği Hastalarında Aileyle Birlikte Yaşamanın Hastalığın Klinik, Demografik ve Laboratuvar Özellikleriyle İlişkisi

Abstract

Amaç: Kalp yetersizliği (KY) ciddi morbidite ve mortalite ile seyredebilen ilerleyici klinik bir sendromdur. KY seyri sırasında tıbbi müdahalelerin yanı sıra, sosyal faktörlerin de klinik sonuçları etkileyebileceği bilinmektedir. Sosyal desteğin KY hastalarında mortalite, olaysız sağ kalım ve yeniden yatış oranlarında tatmin edici gelişmeler sağladığı gösterilmiştir Biz de çalışmamızda en büyük sosyal destekleyici olan aile kavramının KY olgularında klinik özellikler, egzersiz kapasitesi, ekokardiyografik ve laboratuar özellikleri üzerine olan etkilerini ortaya koymayı amaçladık. Yöntem: Çok merkezli, kesitsel olarak yapılan çalışmaya güncel kılavuzlara uygun olarak daha önce KY tanısı koyulan ve ayaktan takip amacıyla poliklinik başvurusu olan 303 hasta dahil edildi. Yeni tanı KY, akut dekompanse KY olan hastalar ile malignite öyküsü olanlar çalışmadan dışlandı. Hastaların demografik verileri (yaş, cinsiyet), komorbiditeler (hipertansiyon, diabetes mellitus, atriyal fibrilasyon vb.), kullandıkları KY tedavileri, laboratuvar testleri ve ayrıntılı transtorasik ekokardiyografi sonuçları dahil olmak üzere ayrıntılı klinik verileri kaydedildi. Hastalar eş, anne, baba veya çocuklarıyla aynı evde yaşıyorsa aile desteği olanlar, bunlardan herhangi biri yoksa aile desteği olmayanlar şeklinde 2 gruba ayrılarak karşılaştırıldı. Bulgular: Çalışmaya 94’ü (%31) kadın ve yaş ortalaması 62,1±13,0 olan 303 KY tanılı hasta dahil edildi. Hastaların ortalama sol ventrikül ejeksiyon fraksiyonu 28,7±8,1 idi. Gruplar komorbiditeler açısından karşılaştırıldığında hipertansiyon, diyabetes mellitus, hiperlipidemi, kronik obstruktif akciğer hastalığı, inme, atrial fibrilasyon varlığı açısından istatistiksel anlamlı fark yoktu (hepsi için, p>0.005). Koroner arter hastalığı aile desteği olan grupta anlamlı şekilde daha sık görülmekteyken kronik böbrek hastalığı ise aile desteği olmayan grupta daha sık izlenmekteydi. (sırasıyla p=0,008 ve p=0,012). Sigara kullanımı aile desteği olmayan grupta anlamlı şekilde daha yüksek iken alkol kullanım oranları arasında fark izlenmedi (sırasıyla p=0,046 ve p=0,602). Yapılan analizler sonunda aile desteği olan gruptaki hastaların KY nedeniyle daha yüksek oranda düzenli takipte olduğu görüldü (%71 vs. %59, p=0,054). Sonuç: KY sahip kişilerde aile bireyleri tarafından oluşturulan sosyal desteğin hastalığın klinik seyri ve hastanın yaşam alışkanlıkları üzerine olumlu etkileri olabileceği görülmüştür.

Keywords

kalp yetersizliği, sosyal destek, aile

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