Unemployment increases risk for death in patients with HF

In patients with HF, unemployment is associated with a 50% higher risk for death and 12% increased risk of rehospitalization for HF, according to findings presented at Heart Failure 2017 in Paris.

“The ability to hold a job brings valuable information on well-being and performance status,” Rasmus Roerth, MD, physician at Copenhagen University Hospital, Denmark, said in a press release. “And workforce exclusion has been associated with increased risk of depression, mental health problems and even suicide.”

Roerth and colleagues studied participants (n = 21,455) aged 18 to 60 years with a first hospitalization for HF between 1997 to 2012. Employment status was assessed at baseline and participants were followed up for all-cause death and recurrent HF hospitalization.

At baseline, 55% of participants were employed. Individuals in the workforce were younger (median age, 53 vs. 55 years), more likely to be men (76% vs. 65%), less likely to have ischemic heart disease (21% vs. 28%) and less likely to have diabetes (12% vs. 23%).

During follow-up, 16% of employed participants died vs. 31% of unemployed participants (HR = 2.09; 95% CI, 1.97-2.21). Of the employed participants, 40% were rehospitalized for HF vs. 42% of unemployed participants (HR = 1.1; 95% CI, 1.05-1.14).

After adjustment for age, sex, education level and comorbidities, unemployed participants were at greater risk for death (HR = 1.49; 95% CI, 1.4-1.59) and greater risk for rehospitalization for HF (HR = 1.12; 95% CI, 1.07-1.17).

Not being employed was associated with a greater risk for death in the cohort than diabetes or stroke, according to the researchers.

The mechanism by which employment status affects individuals with HF outcomes is likely multifactorial, according to the researchers. Working may indicate physical ability, but it also affects quality of life and psychological health, Roerth said in the release.

“It could be highly valuable to assess employment status and actually think of workforce exclusion as a prognostic marker in line with suffering from serious chronic diseases,” Roerth said in the release. “Knowledge on why workforce exclusion has happened for the individual patient might lead to ideas on how it can be prevented — for example with more intensive rehabilitation, physical activity, psychological treatment or a different job.” – by Cassie Homer

Reference:

Roerth R, et al. Abstract 756. Presented at: Heart Failure 2017 and the 4th World Congress on Acute Heart Failure; April 29-May 2, 2017; Paris.

Disclosure: The researchers report no relevant financial disclosures.