Shanghai Jiaotong Daxue xuebao. Yixue ban (Sep 2023)

Effect of somatic symptoms, anxiety and depression on clinical prognosis in patients with chronic heart failure

  • LU Qifan,
  • LIU Qiming,
  • ZHOU Hongmei,
  • CHAI Yezi,
  • JIANG Meng,
  • PU Jun

DOI
https://doi.org/10.3969/j.issn.1674-8115.2023.09.009
Journal volume & issue
Vol. 43, no. 9
pp. 1153 – 1161

Abstract

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Objective·To explore the association of somatizatic symptoms, anxiety and depression with clinical prognosis in the patients with chronic heart failure (CHF).Methods·The patients with CHF who visited the Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to December 2021 were included. Demographic data and clinical features of the patients were collected. The Self-reported Somatic Symptom Scale of China (SSS-CN), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were used to evaluate the patients′ conditions. Telephone follow-up was conducted at the 12th month after the first visit, and the specific information of the patients′ end-point events (including death, re-hospitalization, causes of death and re-hospitalization) was collected. Survival curve and Cox regression analysis were used to evaluate the clinical prognosis of the patients.Results·A total of 195 patients were included. The SSS-CN scores in CHF patients were different between the two genders, among the different heart rate groups and the different cardiac function grades of New York Heart Association (NYHA), also between the patients with anxiety/depression or not (all P<0.05). Survival curve analysis showed that overall survival rate of patients in the moderate-severe somatic symptoms group was lower than that of the patients in the normal-mild group (Log rank P=0.020). Cox regression analysis showed that compared with the normal-mild group, the patients in the moderate-severe somatic symptoms group had a higher risk of all-cause death [hazard ratio (HR)=2.797, 95%CI 1.135－6.890]; the CHF patients with depressive symptoms had a higher risk of all-cause death (HR=2.883, 95%CI 1.150－6.984). Compared with the normal-mild group, the patients with moderate-severe somatic symptoms had a higher risk of cardiovascular death (HR=2.784, 95%CI 1.073－7.226). The CHF patients with depressive symptoms had a higher risk of cardiovascular death (HR=2.823, 95%CI 1.087－7.330). There were no statistically differences in anxiety, depression, somatization symptoms and their severity between all-cause hospitalization and hospitalization due to CHF.Conclusion·The moderate-severe somatic symptoms and depression are the risk factors of all-cause death and cardiovascular death in the patients with CHF.

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