Social network as a predictor of hospital readmission and mortality among older patients with heart failure.
BACKGROUND
This study examines the relationship between social network and hospital readmission and mortality in older patients with heart failure.


RESULTS
Prospective study conducted with 371 patients, age 65 and older, admitted for heart failure-related emergencies at 4 Spanish hospitals. Social network was measured at baseline with a 4-item questionnaire that ascertained whether subjects were married, lived with another person(s), saw or had telephone contact with family members daily or almost daily, and were at home alone for less than 2 hours per day. Social network was deemed "high" where all 4 items were present, "moderate" where 3 were present, and "low" where 2 or fewer were present. Analyses were performed using Cox models, and adjusted for the main confounders. A total of 55% of patients had high or moderate social networks. During a median follow-up of 6.5 months, 135 (36.4%) patients underwent a first emergency rehospitalization and 68 (18.3%) died. Compared with patients with high social network, hospital readmission was more frequent among those who had moderate (hazard ratio [HR] 1.87; 95% confidence interval [CI] 1.06-3.29; P < .05) and low social networks (HR 1.98; 95% CI 1.07-3.68; P < .05). This relationship showed a positive dose-response (p for linear trend 0.042). The magnitude of this association was comparable to that of other important predictors of readmission, such as previous hospitalization. No relationship was observed between social network and death.


CONCLUSIONS
A very simple questionnaire measuring social network can identify patients with a higher short-term risk of hospital readmission.
Rodríguez-Artalejo
Fernando
F
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
Guallar-Castillón
Pilar
P
Herrera
Manuel Conde
MC
Otero
Carmen Montoto
CM
Chiva
Maite Olcoz
MO
Ochoa
Concepción Carreño
CC
Banegas
José R
JR
Pascual
Carlos Rodríguez
CR
D000368:Aged; D000369:Aged, 80 and over; D002303:Cardiac Output, Low / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012944:Social Support; D011795:Surveys and Questionnaires