OBJECTIVE: Health status is an important marker of the impact of disease on function among patients with chronic heart failure (CHF). However, the prognostic value of CHF-specific health status on long-term mortality has not been adequately evaluated. Our objective was to assess CHF-specific health status and 5-year mortality among outpatients with CHF. STUDY DESIGN AND SETTING: We analyzed data from 494 Veterans Affairs outpatients with diagnoses of CHF and objective evidence of left ventricular dysfunction who enrolled in a quality improvement intervention. We extracted information about comorbid diagnoses, severity of illness (Charlson index), health care utilization, drug therapy, laboratory, and vital sign data along with generic and CHF-specific health status. We then identified multivariate correlates of subsequent mortality at 5 years. RESULTS: Five-year mortality was 44%. Age (chi2=26.1, hazard ratio [HR]=1.63, confidence interval [CI]: 1.35, 1.97; P<0.0001) and Charlson index (chi2=12.9, HR=1.39, CI: 1.16, 1.67; P=0.0003) were significantly associated with 5-year mortality. Controlling for clinical, lab, medication, and administrative data, a single-item assessing change in CHF-specific health status was independently associated with 5-year mortality (chi2=11.4, HR=0.87, CI: 0.80, 0.94, P=0.0007). CONCLUSIONS: Given the strength of the association with mortality, health care providers should routinely assess this single-item change in health status among outpatients with CHF to identify higher risk patients and guide therapy.
OBJECTIVE: Health status is an important marker of the impact of disease on function among patients with chronic heart failure (CHF). However, the prognostic value of CHF-specific health status on long-term mortality has not been adequately evaluated. Our objective was to assess CHF-specific health status and 5-year mortality among outpatients with CHF. STUDY DESIGN AND SETTING: We analyzed data from 494 Veterans Affairs outpatients with diagnoses of CHF and objective evidence of left ventricular dysfunction who enrolled in a quality improvement intervention. We extracted information about comorbid diagnoses, severity of illness (Charlson index), health care utilization, drug therapy, laboratory, and vital sign data along with generic and CHF-specific health status. We then identified multivariate correlates of subsequent mortality at 5 years. RESULTS: Five-year mortality was 44%. Age (chi2=26.1, hazard ratio [HR]=1.63, confidence interval [CI]: 1.35, 1.97; P<0.0001) and Charlson index (chi2=12.9, HR=1.39, CI: 1.16, 1.67; P=0.0003) were significantly associated with 5-year mortality. Controlling for clinical, lab, medication, and administrative data, a single-item assessing change in CHF-specific health status was independently associated with 5-year mortality (chi2=11.4, HR=0.87, CI: 0.80, 0.94, P=0.0007). CONCLUSIONS: Given the strength of the association with mortality, health care providers should routinely assess this single-item change in health status among outpatients with CHF to identify higher risk patients and guide therapy.
Authors: Daniel R Reissmann; Antje Erler; Christian Hirsch; Ira Sierwald; Carolina Machuca; Oliver Schierz Journal: Qual Life Res Date: 2017-10-23 Impact factor: 4.147
Authors: Jia-Rong Wu; Debra K Moser; Marla J De Jong; Mary Kay Rayens; Misook L Chung; Barbara Riegel; Terry A Lennie Journal: Am Heart J Date: 2008-12-24 Impact factor: 4.749
Authors: Gillian Stein; Tiew-Hwa K Teng; Wan T Tay; A Mark Richards; Robert Doughty; YanHong Dong; David Sim; Poh S D Yeo; Fazlur Jaufeerally; Gerard Leong; Dinna Soon; Lieng H Ling; Carolyn S P Lam Journal: Clin Cardiol Date: 2020-06-20 Impact factor: 2.882
Authors: Stephanie Bela Andela; Ragna Lamprecht; Mike T John; Swaha Pattanaik; Daniel R Reissmann Journal: Clin Oral Investig Date: 2021-07-06 Impact factor: 3.606