Quin E Denfeld1, Julie T Bidwell2, Jill M Gelow3, James O Mudd4, Christopher V Chien5, Shirin O Hiatt6, Christopher S Lee7. 1. Oregon Health & Science University School of Nursing, SN-ORD, 3455 S.W. U.S. Veterans Hospital Road Portland, OR 97239-2941, USA. Electronic address: denfeldq@ohsu.edu. 2. University of California Davis Betty Irene Moore School of Nursing, Sacramento, CA, USA. 3. Providence Heart & Vascular Institute, Portland, OR, USA. 4. Providence Sacred Heart Medical Center, Spokane, WA, USA. 5. University of North Carolina, REX Healthcare, Raleigh, NC, USA. 6. Oregon Health & Science University School of Nursing, SN-ORD, 3455 S.W. U.S. Veterans Hospital Road Portland, OR 97239-2941, USA. 7. Boston College William F. Connell School of Nursing, Chestnut Hill, MA, USA.
Abstract
BACKGROUND: The relationship between physical and affective symptom clusters in heart failure (HF) is unclear. OBJECTIVES: To identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups. METHODS: This was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively. RESULTS: In this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3%), incongruent (13.9%), and congruent-severe (16.8%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival. CONCLUSION: Congruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.
BACKGROUND: The relationship between physical and affective symptom clusters in heart failure (HF) is unclear. OBJECTIVES: To identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups. METHODS: This was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively. RESULTS: In this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3%), incongruent (13.9%), and congruent-severe (16.8%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival. CONCLUSION: Congruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.
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