Disease‐specific health status as a predictor of mortality in patients with heart failure: a systematic literature review and meta‐analysis of prospective cohort studies

Abstract

Aims Some, but not all, studies have shown that patient‐reported health status, including symptoms, functioning, and health‐related quality of life, provides additional information to traditional clinical factors in predicting prognosis in heart failure patients. To evaluate the overall evidence, the association of disease‐specific health status on mortality in heart failure was examined through a systematic review and meta‐analysis. Methods and results Prospective cohort studies that assessed the independent association of disease‐specific health status with mortality in heart failure were selected. Searching PubMed (until March 2013) resulted in 17 articles in the systematic review and 17 studies in the meta‐analysis. About half of the studies reported a significant relationship between disease‐specific health status and mortality in heart failure, while the remainder found no association. A larger sample size increased the chance of identification of a significant association. The results of the meta‐analysis (including studies using a dichotomized heart failure‐specific health status variable as predictor) showed that heart failure patients reporting poor disease‐specific health status had a 39% increased risk of dying [hazard ratio 1.39 (1.25–1.54)] when compared with patients experiencing moderate or good disease‐specific health status. Conclusion Patient‐reported health status was an independent risk indicator for mortality in heart failure patients and may facilitate the identification of patients at high risk for poor prognosis above and beyond traditional risk variables. These findings suggest that patient‐reported health status should be routinely assessed in determining prognosis, as this information cannot be captured from patients' medical records.

Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

“…In recent years HRQOL and patient-reported health status have gained considerable interest on various levels. 178 Cardiac patients with poor self-reported HRQOL tend to have higher rates of re-infarction and rehospitalisation, 179,180 and they are less likely to be invited to, or to attend CR.…”

Reply to letter from I. Ekman, K. Swedberg, and M. Böhm

“…1 We have been able to establish why the Systolic Heart failure treatment with the I f inhibitor ivabradine Trial (SHIFT) study was not identified in our original search. The original search was conducted as follows: (quality of life OR health status OR self-rated health OR functional status OR functioning) AND (hospitalization OR readmission OR mortality OR survival OR prognosis) AND (heart failure OR CHF), with 'hospitalization' as 'MeSH' term and other search terms using 'Title/Abstract'.…”

The Impact of Relationship Quality on Health-Related Outcomes in Heart Failure Patients and Informal Family Caregivers

“…Studies were included in the review if they (1) included HF patients and their respective informal family caregivers; (2) measured or described relationship quality chosen because (1) mortality is considered the ''single best measure of health'' 27(p721) because it is 1 of the most reliable and a valid measures of health available and (2) health status, 28 distress or depressive symptoms, 29 and caregiver burden 5 have all been shown to be related to mortality risk. Studies were excluded if they were unpublished manuscripts (abstracts or dissertations), case studies, reviews of the literature, or not available in English.…”