2.50
Hdl Handle:
http://hdl.handle.net/10755/157565
Type:
Presentation
Title:
Cardiac Cachexia: The Psychological Side of the Story
Abstract:
Cardiac Cachexia: The Psychological Side of the Story
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Moughrabi, Samira, PhDc
P.I. Institution Name:University of California, Los Angeles, School of Nursing
Title:Doctoral Candidate
Contact Address:3-653 Factor Bldg, Box 696917, Los Angeles, CA, 90095-6917, USA
Contact Telephone:818-825-6424
Co-Authors:Lorraine S. Evangelista, RN, PhD, Professor
Purpose: This descriptive, correlational study was conducted to compare levels of depression among cardiac cachectic and non-cachectic patients with chronic heart failure (HF) and determine whether depression is an independent predictor of cardiac cachexia (CC). We hypothesized that cachectic patients would have higher depression scores and that depression is an independent predictor of CC. Background: Cardiac cachexia, defined as non-edematous weight loss of at least 6% over at least 6 months, is a serious complication of HF. The syndrome is associated with progressive body wasting affecting all tissue compartments, poor outcomes, and increased mortality.  Multiple clinical and biological correlates of CC have been well documented; however, little is known about psychological correlates. Methods: One hundred and fourteen patients in a university-affiliated, multidisciplinary HF clinic (age 56 +/- 13 years, ejection fraction (EF) 33 +/- 12%, 68% male, 57% Caucasian) completed the Patient Health Questionnaire-9 to assess levels of depression. Clinical variables (EF, New York Heart Association class, peak VO2, body mass index), and demographic variables (age, gender, race) were obtained from the medical record and included in the analyses.  T-test for independent groups and Mann-Whitney U Wilcoxon W tests were used to compare cachectic (10.5%) and non-cachectic (89.5%) subjects on parametric and non-parametric variables, respectively.  Stepwise logistic regression analysis was performed to determine the independent predictors of CC.   Results: Both cachectic and non-cachectic groups were statistically comparable in relation to age, gender, medication use, comorbidities, smoking and alcohol use, and functional status. Cachectic subjects had significantly lower EF (mean=24.5 vs. 34.2, respectively, p=.009) and higher depression scores (mean=7.17 vs. 4.27, respectively, p=.018) as compared to non-cachectic subjects.  Multivariate logistic regression analysis showed that cachectic patients were more likely to be depressed than non-cachectic patients (odds ratio 1.23; confidence interval 1.024 - 1.48; p=.027). Implications: The current study is the first study to show that a relationship exists between CC and depression.  The data generated from this study highlight the need for healthcare professionals to implement interventions to alleviate depression in patients with HF. Moreover, this study underscores the need for larger scale research that take into account levels of depression among HF patients, particularly those with CC.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCardiac Cachexia: The Psychological Side of the Storyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157565-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Cardiac Cachexia: The Psychological Side of the Story</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Moughrabi, Samira, PhDc</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California, Los Angeles, School of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Doctoral Candidate</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3-653 Factor Bldg, Box 696917, Los Angeles, CA, 90095-6917, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">818-825-6424</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">smoughrabi@gmail.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Lorraine S. Evangelista, RN, PhD, Professor</td></tr><tr><td colspan="2" class="item-abstract">Purpose: This descriptive, correlational study was conducted to compare levels of depression among cardiac cachectic and non-cachectic patients with chronic heart failure (HF) and determine whether depression is an independent predictor of cardiac cachexia (CC). We hypothesized that cachectic patients would have higher depression scores and that depression is an independent predictor of CC. Background: Cardiac cachexia, defined as non-edematous weight loss of at least 6% over at least 6 months, is a serious complication of HF.&nbsp;The syndrome is associated with progressive body wasting affecting all tissue compartments, poor outcomes, and increased mortality.&nbsp; Multiple clinical and biological correlates of CC have been well documented; however, little is known about psychological correlates. Methods: One hundred and fourteen patients in a university-affiliated, multidisciplinary HF clinic (age 56 +/- 13 years, ejection fraction (EF) 33 +/- 12%, 68% male, 57% Caucasian) completed the Patient Health Questionnaire-9 to assess levels of depression. Clinical variables (EF, New York Heart Association class, peak VO2, body mass index), and demographic variables (age, gender, race) were obtained from the medical record and included in the analyses.&nbsp; T-test for independent groups and Mann-Whitney U Wilcoxon W tests were used to compare cachectic (10.5%) and non-cachectic (89.5%) subjects on parametric and non-parametric variables, respectively.&nbsp; Stepwise logistic regression analysis was performed to determine the independent predictors of CC.&nbsp;&nbsp; Results: Both cachectic and non-cachectic groups were statistically comparable in relation to age, gender, medication use, comorbidities, smoking and alcohol use, and functional status. Cachectic subjects had significantly lower EF (mean=24.5 vs. 34.2, respectively, p=.009) and higher depression scores (mean=7.17 vs. 4.27, respectively, p=.018) as compared to non-cachectic subjects.&nbsp; Multivariate logistic regression analysis showed that cachectic patients were more likely to be depressed than non-cachectic patients (odds ratio 1.23; confidence interval 1.024 - 1.48; p=.027). Implications: The current study is the first study to show that a relationship exists between CC and depression.&nbsp; The data generated from this study highlight the need for healthcare professionals to implement interventions to alleviate depression in patients with HF.&nbsp;Moreover, this study underscores the need for larger scale research that take into account levels of depression among HF patients, particularly those with CC.</td></tr></table>en_GB
dc.date.available2011-10-26T19:59:26Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:59:26Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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