Abstract 11275: Comorbidity Score is Positively Associated With Hopelessness in Adults With Ischemic Heart Disease

Abstract

Introduction: Comorbidities are associated with increased risk of mortality in adults with ischemic heart disease (IHD). Hopelessness, a negative outlook and sense of helplessness towards the future, is identified in 27–52% of patients with IHD and associated with a 3.4 times increased risk of mortality or nonfatal myocardial infarction. The relationship between comorbidities and hopelessness in adults with IHD is unknown. Hypothesis: A higher comorbidity score is positively associated with state and trait hopelessness levels in adults hospitalized with an IHD event. Methods: Participants completed the State-Trait Hopelessness Scale and reported basic demographics. Continuous (range 0-14) and categorical scores for the Charlson Comorbidity Index (CCI) were generated based on patient medical records. Results: Participants (n=132) were typical of the U.S. IHD population except for race/ethnicity. Ninety-one were male (68.4%), mean age was 62.6 years (SD= 9.6), and 97% were non-Latinx White (3.0%). The mean CCI was 3.5 (SD=2.2), with 36.4% having a score of 1-2 (mild), 41.2% with a score of 3-4 (moderate) and 22.7% with a score of ≥5 (severe). The CCI was positively associated with both state and trait hopelessness in unadjusted and adjusted (demographics, medical history, and exercise history) analyses (unadjusted: r=0.26, p=0.002 (state); r=0.23, p=0.009 (trait) and adjusted: r=0.22, p=0.008 (state); r=0.18, p=0.052 (trait)). Components of the CCI showing the strongest relationships with higher levels of hopelessness were cerebrovascular accident (n=8), organ damage from diabetes (n=17), COPD (n=24), and renal failure (n=9). Interaction terms were evaluated and there was no evidence that the relationship between the CCI and hopelessness differed by age, gender, education level, or cardiac intervention type. Conclusions: Our hypothesis of a positive association between comorbidity score and state and trait hopelessness was confirmed. Knowledge of hopelessness in IHD patients with comorbidities is important for health care professionals in acute care and outpatient settings so at-risk patients can be identified and appropirate interventions employed. Future work should be conducted in larger, more heterogeneous samples.