Living alone and gender differences in rehospitalization for heart failure after discharge among acute heart failure patients

Abstract

Home treatment for heart failure (HF) is one of the most important problems in patients after discharge as a secondary preventive measure for rehospitalization for HF. However, there are no detailed studies on gender differences in sociopsychological factors such as living alone for HF rehospitalization among patients with acute HF (AHF). This prospective multicenter cohort study enrolled patients with AHF between April 2015 and August 2017. Patients of each gender with first AHF were divided into those living alone and those not living alone. The primary endpoint was defined as rehospitalization for HF after discharge. Cox proportional hazard analysis was performed to determine the association between living alone and the endpoint. Overall, 581 patients were included in this study during the 3-year follow-up. The proportion of rehospi-talization for HF was significantly higher in patients living alone than in those not living alone among male pa-tients. However, female patients showed no difference in endpoints between the two groups. The difference was independently maintained even after adjusting for differences in social backgrounds in male patients (adjusted hazard ratio (HR) 2.02; 95% confidence interval (CI), 1.07-3.70). In female patients, the HR for rehospitaliza-tion for HF showed no difference between the two groups (adjusted HR, 0.99; 95% CI, 0.56-1.69). In this study population, male patients living alone after first AHF discharge had a higher risk of rehospi-talization for HF than those not living alone, but these differences were not observed in female patients.