Quality of life predicts outcome in a heart failure disease management program.
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Authors
O'Loughlin, ChristinaMurphy, Niamh F
Conlon, Carmel
O'Donovan, Aoife
Ledwidge, Mark
McDonald, Ken
Affiliation
Department of Cardiology, St Vincent's University Hospital, Dublin, Ireland.Issue Date
2012-02-01T10:34:36ZMeSH
AgedAged, 80 and over
*Ambulatory Care
Chronic Disease
Disease Management
Female
*Health Status
*Heart Failure/mortality/physiopathology/therapy
Humans
Male
Middle Aged
Minnesota/epidemiology
Multivariate Analysis
Outcome Assessment (Health Care)
Patient Readmission/statistics & numerical data
Predictive Value of Tests
*Quality of Life
Questionnaires
Retrospective Studies
Risk Factors
Severity of Illness Index
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Int J Cardiol. 2010 Feb 18;139(1):60-7. Epub 2008 Oct 12.Journal
International journal of cardiologyDOI
10.1016/j.ijcard.2008.09.003PubMed ID
18851887Abstract
BACKGROUND: Chronic heart failure (HF) is associated with a poor Health Related Quality of Life (HRQoL). HRQoL has been shown to be a predictor of HF outcomes however, variability in the study designs make it difficult to apply these findings to a clinical setting. The aim of this study was to establish if HRQoL is a predictor of long-term mortality and morbidity in HF patients followed-up in a disease management program (DMP) and if a HRQoL instrument could be applied to aid in identifying high-risk patients within a clinical context. METHODS: This is a retrospective analysis of HF patients attending a DMP with 18+/-9 months follow-up. Clinical and biochemical parameters were recorded on discharge from index HF admission and HRQoL measures were recorded at 2 weeks post index admission. RESULTS: 225 patients were enrolled into the study (mean age=69+/-12 years, male=61%, and 78%=systolic HF). In multivariable analysis, all dimensions of HRQoL (measured by the Minnesota Living with HF Questionnaire) were independent predictors of both mortality and readmissions particularly in patients <80 years. A significant interaction between HRQoL and age (Total((HRQoL))age: p<0.001) indicated that the association of HRQoL with outcomes diminished as age increased. CONCLUSIONS: These data demonstrate that HRQoL is a predictor of outcome in HF patients managed in a DMP. Younger patients (<65 years) with a Total HRQoL score of > or =50 are at high risk of an adverse outcome. In older patients > or =80 years HRQoL is not useful in predicting outcome.Language
engISSN
1874-1754 (Electronic)0167-5273 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1016/j.ijcard.2008.09.003
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