Quality of life predicts outcome in a heart failure disease management program.

Hdl Handle:
http://hdl.handle.net/10147/207674
Title:
Quality of life predicts outcome in a heart failure disease management program.
Authors:
O'Loughlin, Christina; Murphy, Niamh F; Conlon, Carmel; O'Donovan, Aoife; Ledwidge, Mark; McDonald, Ken
Affiliation:
Department of Cardiology, St Vincent's University Hospital, Dublin, Ireland.
Citation:
Int J Cardiol. 2010 Feb 18;139(1):60-7. Epub 2008 Oct 12.
Journal:
International journal of cardiology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207674
DOI:
10.1016/j.ijcard.2008.09.003
PubMed ID:
18851887
Abstract:
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:
eng
MeSH:
Aged; Aged, 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
ISSN:
1874-1754 (Electronic); 0167-5273 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Loughlin, Christinaen_GB
dc.contributor.authorMurphy, Niamh Fen_GB
dc.contributor.authorConlon, Carmelen_GB
dc.contributor.authorO'Donovan, Aoifeen_GB
dc.contributor.authorLedwidge, Marken_GB
dc.contributor.authorMcDonald, Kenen_GB
dc.date.accessioned2012-02-01T10:34:36Z-
dc.date.available2012-02-01T10:34:36Z-
dc.date.issued2012-02-01T10:34:36Z-
dc.identifier.citationInt J Cardiol. 2010 Feb 18;139(1):60-7. Epub 2008 Oct 12.en_GB
dc.identifier.issn1874-1754 (Electronic)en_GB
dc.identifier.issn0167-5273 (Linking)en_GB
dc.identifier.pmid18851887en_GB
dc.identifier.doi10.1016/j.ijcard.2008.09.003en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207674-
dc.description.abstractBACKGROUND: 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.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.mesh*Ambulatory Careen_GB
dc.subject.meshChronic Diseaseen_GB
dc.subject.meshDisease Managementen_GB
dc.subject.meshFemaleen_GB
dc.subject.mesh*Health Statusen_GB
dc.subject.mesh*Heart Failure/mortality/physiopathology/therapyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMinnesota/epidemiologyen_GB
dc.subject.meshMultivariate Analysisen_GB
dc.subject.meshOutcome Assessment (Health Care)en_GB
dc.subject.meshPatient Readmission/statistics & numerical dataen_GB
dc.subject.meshPredictive Value of Testsen_GB
dc.subject.mesh*Quality of Lifeen_GB
dc.subject.meshQuestionnairesen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshSeverity of Illness Indexen_GB
dc.titleQuality of life predicts outcome in a heart failure disease management program.en_GB
dc.contributor.departmentDepartment of Cardiology, St Vincent's University Hospital, Dublin, Ireland.en_GB
dc.identifier.journalInternational journal of cardiologyen_GB
dc.description.provinceLeinster-

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