Association between having a caregiver and clinical outcomes 1 year after hospitalization for cardiovascular disease Article

Mosca, L, Aggarwal, B, Mochari-Greenberger, H et al. (2012). Association between having a caregiver and clinical outcomes 1 year after hospitalization for cardiovascular disease . AMERICAN JOURNAL OF CARDIOLOGY, 109(1), 135-139. 10.1016/j.amjcard.2011.07.072

cited authors

  • Mosca, L; Aggarwal, B; Mochari-Greenberger, H; Liao, M; Blair, J; Cheng, B; Comellas, M; Rehm, L; Suero-Tejeda, N; Umann, T

authors

abstract

  • Caregivers might represent an opportunity to improve cardiovascular disease outcomes, but prospective data are limited. We studied 3,188 consecutive patients (41% minority, 39% women) admitted to a university hospital medical cardiovascular service to evaluate the association between having a caregiver and rehospitalization/death at 1 year. The clinical outcomes at 1 year were documented using a hospital-based clinical information system supplemented by a standardized questionnaire. Co-morbidities were documented by hospital electronic record review. At baseline, 13% (n = 417) of the patients had a paid caregiver and 25% (n = 789) had only an informal caregiver. Having a caregiver was associated with rehospitalization or death at 1 year (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.45 to 1.95), which varied by paid (OR 2.46, 95% CI 1.96 to 3.09) and informal (OR 1.40, 95% CI 1.18 to 1.65) caregiver status. Having a caregiver was significantly (p <0.05) associated with age <65 years, racial/ethnic minority, lack of health insurance, medical history of diabetes mellitus or hypertension, a Ghali co-morbidity index >1, chronic obstructive pulmonary disease, or taking <9 prescriptions medications. The relation between caregiving and rehospitalization/death at 1 year was attenuated but remained significant after adjustment (paid, OR 1.64, 95% CI 1.26 to 2.12; and informal, OR 1.20, 95% CI 1.00 to 1.44). In conclusion, the risk of rehospitalization/death was significantly greater among cardiac patients with caregivers and was not fully explained by the presence of traditional co-morbidities. Systematic determination of having a caregiver might be a simple method to identify patients at a heightened risk of poor clinical outcomes. © 2012 Elsevier Inc. All rights reserved.

publication date

  • January 1, 2012

published in

Digital Object Identifier (DOI)

start page

  • 135

end page

  • 139

volume

  • 109

issue

  • 1