Predictors of patient-reported outcomes at discharge in patients with heart failure

Abstract

Background: It is well-established that heart failure has a negative impact on quality of life. However, little is known about patient-related predictors of health-related quality of life, anxiety and depression, symptoms and illness perception among patients with heart failure. Aim: To study the association between patient-related predictors and patient-reported outcome measures at discharge from hospital in a cohort of patients with heart failure. Methods: We used data from 1506 patients with heart failure, participating in the national DenHeart Survey of patient-reported outcome measures in patients with heart disease. The potential patient-related predictors included demographic, administrative, clinical and socioeconomic factors. The patient-reported outcome measures included six questionnaires: the Short Form-12, the Hospital Anxiety and Depression Scale, the EuroQol five-dimensional, five-level questionnaire, the HeartQoL, the Brief Illness Perception Questionnaire and the Edmonton Symptom Assessment Scale. Data were linked to national patient registry data and medical records. We performed multivariable linear and logistic regression analyses. Results: In adjusted linear regression analyses we found that a length of hospital stay of >2 days was associated with worse scores across questionnaires, except for the Brief Illness Perception Questionnaire. Higher comorbidity level was associated with worse scores across all questionnaires, whereas low social support was associated with worse scores across questionnaires, except for the physical domain of the Short Form-12 and the HeartQoL global score. Conclusions: This study identified length of hospital stay > 2 days, a higher comorbidity level and low social support to be associated with worse scores across questionnaires at discharge from a cardiac-related hospitalisation in patients with heart failure.

Impact analysis of heart failure across European countries: an ESC‐HFA position paper

“…Furthermore, depression, higher comorbidity level, and low social support are found to be related to poor QOL in patients with HF. 71 These data highlight the urgent need for optimal multidisciplinary HF management, including optimal medication and device treatment, patient education, and self-care support, 72 to improve QOL in this vulnerable population. 9, [73][74][75] Relatively new therapies, such as sacubitril/valsartan, and the SGLT2i drugs dapagliflozin and empagliflozin have demonstrated notable improvements in patients' QOL 58,76,77 as have implanted device therapies (e.g.…”

“…Furthermore, depression, higher comorbidity level, and low social support are found to be related to poor QOL in patients with HF. 71 …”

“…More starkly, these patients also had an increased risk of hospital admissions and death. Furthermore, depression, higher comorbidity level, and low social support are found to be related to poor QOL in patients with HF 71 …”

Sleep Characteristics, Mood, Somatic Symptoms, and Self-Care Among People With Heart Failure and Insomnia

“…People with HF often report disturbed mood (e.g., anxiety, depression, and stress) and somatic symptoms such as dyspnea, fatigue, and sleepiness (Gaffey et al, 2021; Park et al, 2019; Rasmussen et al, 2020). Abnormal sleep characteristics, including sleep disturbance; self-reported sleep quality; short, fragmented, and irregular sleep; and specific sleep disorders such as chronic insomnia and sleep-disordered breathing are also common (Redeker et al, 2010; Spedale et al, 2021).…”