Association of living alone with clinical outcomes in patients with heart failure: A systematic review and meta‐analysis

Abstract

AbstractLiving alone is an objective sign of social isolation. It is uncertain whether living alone worsens clinical outcomes in heart failure (HF) patients. We aimed to assess how living alone affected clinical outcomes in individuals with HF. We searched the electronic databases of PubMed, Embase, and Cochrane from 1990 to April 2022 for studies comparing living alone with HF. A random‐effects model with inverse variance was used to pool adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Seven studies were deemed to meet the standards. In patients with HF, compared with living with others, living alone was associated with an elevated risk of any hospitalization at the 30‐day (HR: 1.78, 95% CI: 1.09–2.89), 90‐day (HR: 1.24, 95% CI: 1.02–1.51), or ≥1‐year (HR: 1.14, 95% CI: 1.04–1.26) follow‐up periods. HF patients living alone also had a greater risk of any hospitalization or death at the 30‐day (HR: 1.56, 95% CI: 1.15–2.11), 90‐day (HR: 1.26, 95% CI: 1.05–1.50), and ≥1‐year (HR: 1.18, 95% CI: 1.09–1.28) follow‐up periods. However, patients living alone had no increased risk of all‐cause death at the 30‐day (HR: 1.0, 95% CI: 0.19–5.36), 90‐day (HR: 0.46, 95% CI: 0.03–7.42), or ≥ 1‐year (HR: 1.10, 95% CI: 0.73–1.67) follow‐up periods. In comparison to living with others, living alone was associated with an increased risk of any hospitalization but not all‐cause death in HF patients.