Unemployed heart failure patients could face 50% higher risk of death

Being unemployed could have deadly consequences for patients suffering from heart failure, a new study finds.

The research, conducted by physicians at Copenhagen University Hospital in Denmark, was presented at Heart Failure 2017, an annual conference hosted by the European Society of Cardiology. The study was published in the European Heart Journal.

Findings showed that unemployment is associated with a 50 percent higher risk of death in patients with heart failure than those with a history of diabetes or stroke.

"The ability to hold a job brings valuable information on wellbeing and performance status," said Rasmus Roerth, MD, the lead author on the study and a physician at Copenhagen, in a statement. "And workforce exclusion has been associated with increased risk of depression, mental health problems and even suicide. In younger patients with heart failure, employment status could be a potential predictor of morbidity and mortality. If that was the case, employment status could help to risk stratify young heart failure patients and identify those needing more intensive rehabilitation."

The observational study included more than 20,000 heart failure patients and compared the risks of all-cause death and recurrent heart failure hospitalizations in patients with heart failure. Data was pulled from registries on hospitalizations, prescribed medication, education level, public welfare payments and death.

Patients had a hospitalization for heart failure in Denmark between 1997 and 2012. Of the 21,455 patients with hospitalizations, 55 percent had a job at baseline.

During follow up periods, 16 percent of employed and 31 percent of unemployed patients died, while 40 percent of employed and 42 percent of unemployed patients were re-hospitalized for heart failure.

After adjusting for age, gender, education level and other factors, findings showed that unemployed heart failure patients at baseline had a 50 percent increased risk of death and a 12 percent increased risk of being re-hospitalized.

"We found that heart failure patients out of the workforce at baseline had a higher risk of death,” Roerth said. “Not being part of the workforce was associated with a risk of death comparable to that of having diabetes or stroke. Those without a job also had an increased risk of recurrent heart failure hospitalization."

Additionally, he noted in the study that the findings could be used by physicians to screen and predict which patients might be at risk for death by heart failure.

"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. "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."