Quality of life monitoring in ambulatory heart failure patients: temporal changes and prognostic value. (January 2013)

• Record Type: Journal Article
• Authors: Lupón, Josep; Gastelurrutia, Paloma; de, Marta; González, Beatriz; Cano, Lucía; Cabanes, Roser; Urrutia, Agustín; Díez, Crisanto; Coll, Ramón; Altimir, Salvador; Bayes‐Genis, Antoni
• Is Part Of: European journal of heart failure. Volume 15:Number 1(2013)
• Page Start: 103
• Page End: 109
• Publication Date: 2013-01
• Subjects: Heart failure -- Periodicals; Heart Failure -- Periodicals; Insuffisance cardiaque -- Périodiques; Heart failure; Periodicals; 616.129005
• DOI: 10.1093/eurjhf/hfs133
• Languages: English
• ISSNs: 1388-9842

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ejhfhfs133-sec-0001" sec-type="section"> <title>Aims</title> <p>Heart failure (HF) is a chronic condition that typically affects a patient's quality of life (QoL). Little is known about long‐term QoL monitoring in HF. This study aimed to evaluate the temporal changes and prognostic value of QoL assessment in a real‐life cohort of HF patients.</p> </sec> <sec id="ejhfhfs133-sec-0002" sec-type="section"> <title>Methods and results</title> <p>The Minnesota Living with Heart Failure Questionnaire was used to monitor QoL at baseline and at 1, 3, and 5 years for 1151 consecutive patients {71.7% men, median age 69 years [25th–75th percentiles (P<sub>25</sub>–P<sub>75</sub>) 59–76]} in an HF unit. Follow‐up for prognosis assessment was extended to 6 years. The number of answered questionnaires was 1151 at baseline, 746 at 1 year, 268 at 3 years, and 240 at 5 years. QoL scores showed a steep decrease (indicating QoL improvement) during the first year [29 (P<sub>25</sub>–P<sub>75</sub> 16–43) at baseline vs. 15 (P<sub>25</sub>–P<sub>75</sub> 8–27) at 1 year, <italic>P</italic> < 0.001], which was tempered, yet significant up to 5 years [12 (P<sub>25</sub>–P<sub>75</sub> 7–23) at 3 years vs. 10 (P<sub>25</sub>–P<sub>75</sub> 5–21) at 5 years, <italic>P</italic> = 0.012]. We recorded 457 deaths during follow‐up. In a comprehensive multivariable Cox regression analysis, baseline QoL remained a significant prognosticator during follow‐up [hazard ratio (HR)<sub>Cox</sub> for death 1.012, 95% confidence interval 1.006–1.018, <italic>P</italic> < 0.001]. QoL monitoring showed that a score increase ≥10% between consecutive assessments stratified high‐risk patients within the next 12 months (<italic>P</italic> = 0.008).</p> </sec> <sec id="ejhfhfs133-sec-0003" sec-type="section"> <title>Conclusion</title> <p>Both baseline and follow‐up QoL monitoring were useful for patient risk stratification in a real‐life HF cohort. Worse QoL may warn of a worse prognosis. Widespread QoL monitoring in routine clinical practice is recommended.</p> </sec> </abstract>