Effect of anxiety and depression on prognosis of elderly patients with heart failure

Objective To study the incidence and related factors of anxiety and depression in elderly patients with heart failure,explore the effect of anxiety and depression on the prognosis of patients,and provide the basis for the treatment of elderly patients with heart failure. Methods Total 225 elderly patients with heart failure were collected in Xuanwu hospital of Capital Medical University from June,2014 to June,2015.Zung self-rating Anxiety Scale(SAS) and self-rating Depression Scale(SDS) were used to analyze the incidence of anxiety and depression;According to the prognosis,49 cases were divided into death group,176 cases were divided into survival group,t test was used to compare the difference of SDS and SAS score between the death group and the survival group;According to SAS and SDS,112 patients with anxiety,113 patients with no anxiety,168 patients with depression,57 patients with no depression,the application of chi square test were used to compare the difference of SAS and SDS between the anxiety and depression groups and no anxiety and depression groups respectively;The influence of age,gender,income,heart function,culture degree and living alone and other factors on the anxiety and depression were analyzed by using multivariate logistic regression analysis of correlation. Results The incidence of anxiety was 63.6%(112/225)in elderly patients with heart failure,and the incidence of depression was 74.6%(168/225).The SAS and SDS score in the death group were 61.30±6.79 and 65.32±5.85 respectively,the SAS and SDS scores in the survival group were 54.06±7.67 and 55.68±7.62 respectively,the SAS and SDS scores in the death group were higher than those in the survival group,the difference between the two groups was statistically significant(P=0.001,0.001).The mortality rate in anxiety group was 41.07%(46/112),the mortality rate in no anxiety group was 2.6%(3/113),the mortality in the anxiety group was significantly higher than that in no anxiety group(χ²=26.83,P=0.001).The mortality rate in depression group was 27.9%(47/168),the mortality rate in no depression group was 3.5%(2/57),the mortality rate in depression group was significantly higher than that in no depression group(χ²=14.95,P=0.001).Multivariate logistic regression analysis showed that the heart function,alone and the degree of culture were significantly related with the anxiety(P<0.01),the heart function and culture degree were significantly related with depression(P<0.05). Conclusion The incidence of depression and anxiety in elderly patients with heart failure were higher,these could affect the prognosis of patients,the related factors for active intervention should be done to deal with the anxiety and depression.