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Meta-Analysis
. 2019 Jan-Feb;71(1):52-59.
doi: 10.1016/j.ihj.2018.12.006. Epub 2019 Jan 3.

Cognitive impairment and 30-day rehospitalization rate in patients with acute heart failure: A systematic review and meta-analysis

Jakrin Kewcharoen  1 , Angkawipa Trongtorsak  2 , Chanavuth Kanitsoraphan  3 , Narut Prasitlumkum  3 , Raktham Mekritthikrai  3 , Chol Techorueangwiwat  2 , Nath Limpruttidham  3 , Pattara Rattanawong  3
Affiliations
Meta-Analysis

Cognitive impairment and 30-day rehospitalization rate in patients with acute heart failure: A systematic review and meta-analysis

Jakrin Kewcharoen et al. Indian Heart J. 2019 Jan-Feb.

Abstract

Background: Heart failure (HF) is one of the world leading causes of hospitalization and rehospitalization. Cognitive impairment has been identified as a risk factor for rehospitalization in patients with heart failure. However, previous studies reported mixed results. Therefore, we conducted a systematic review and meta-analysis to assess the association between cognitive impairment and 30-day rehospitalization in patients with HF.

Method: We performed a comprehensive literature search through July 2018 in the databases of MEDLINE and EMBASE. Included studies were cohort studies, case-control studies, cross-sectional studies or randomized controlled trials that compared the risk of 30-day rehospitalization in HF patients with cognitive impairment and those without. We calculated pooled relative risk (RR) with 95% confidence intervals (CI) and I2 statistic using the random-effects model.

Results: Five studies with a total of 2,342 participants (1,004 participants had cognitive impairment) were included for meta-analysis. In random-effect model, cognitive impairment significantly increased the risk of 30-day rehospitalization in HF participants (pooled RR=1.63, 95%CI: 1.19-2.24], I2=64.2%, p=0.002). Subgroup analysis was performed on the studies that excluded patients with dementia. The results also showed that cognitive impairment significantly increased the risk of 30-day rehospitalization in participants with HF (pooled RR=1.29, 95%CI: 1.05-1.59, I2=0.0%, p=0.016), which was consistent with our overall analysis.

Conclusion: Our meta-analysis demonstrated that the presence of cognitive impairment is associated with 30-day rehospitalization in patients with HF.

Keywords: cognitive dysfunction; cognitive impairment; heart failure; rehospitalization.

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Figures

Fig. 1
Fig. 1
PRISMA 2009 flow diagram.
Fig. 2
Fig. 2
The forest plot of the included studies assessing the association between cognitive impairment and 30-day rehospitalization in patients with acute heart failure. CI, confidence interval.
Fig. 3
Fig. 3
Forest plot of the subgroup analysis of studies that excluded patients with dementia, assessing the association between cognitive impairment and 30-day rehospitalization in patients with acute heart failure. CI, confidence interval.
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See this image and copyright information in PMC

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