History of depression as a predictor of adverse outcomes in patients hospitalized for decompensated heart failure

Study Objective. To evaluate the prevalence and impact of depression on the risk of in-hospital death or need for cardiopulmonary resuscitation (CPR) in patients admitted for decompensated heart failure. Design. Observational single-center study. Setting. Coronary care unit and cardiac intermediate-care unit of a tertiary referral center. Patients. One hundred seventy-one patients hospitalized with decompensated heart failure who were included in the Acute Decompensated Heart Failure Registry (ADHERE). Measurements and Main Results. The 34 patients with a history of depression had a higher likelihood of experiencing the combined end point of in-hospital death or CPR compared with the 137 patients without a history of depression (17.7% vs 6.6%, p<0.05). A history of depression (odds ratio 3.3, 95% confidence interval 1.01-10.6, p<0.05) was still predictive of in-hospital death or CPR in a multivariate analysis after adjusting for predictors of the combined end point. Conclusions. This study suggests that a history of depression is associated with an increased risk of in-hospital mortality or CPR in patients hospitalized for decompensated heart failure. Our results require confirmation in larger trials.