Quality of Life Predicts Survival and Hospitalisation in a Heart Failure Portuguese Population

Abstract

The aim of this study was to examine whether quality of life (QoL) is an independent predictor of death and hospitalization for cardiovascular (CV) causes in patients with heart failure (HF). A 6-year prospective study was conducted on 130 outpatients with HF who were recruited from a cardiology service at S. João Hospital. Generic QoL was measured with the Medical Outcome Study 36-item Short Form Survey (SF-36), disease-specific QoL was measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Beck Depression Inventory Scale (BDI-II) was used to screen for depressive symptoms (DS). Logistic regression and multinomial logistic regression analysis were used to evaluate the independent prognostic value of QoL measures on all cause mortality and hospitalization for CV causes after adjustment for clinical risk factors. During the follow-up 48 % of the participants died for all causes and 38 % were hospitalized for CV causes. Both generic and disease-specific QoL instruments were predictive of mortality and hospitalization on univariate analysis. After adjustment for prognostic factors such as DS, age, gender, B-type natriuretic peptide (BNP) levels, renal insufficiency and functional class NHYA only the summary clinical domain of KCCQ remained predictive of mortality. With respect to hospitalization for CV causes remained the predictive power: the summary clinical domain and the self-efficacy domains of KCCQ and the physical health domain of SF-36. Worse Applied Research Quality Life 4 Rua Cândido Beirante n°6, 4715-269 Braga, PortugalQoL is associated with all-cause death and hospitalization for CV causes in patients with HF and its impact persists over 6 years.

Myocardial Contraction Fraction by M-Mode Echocardiography Is Superior to Ejection Fraction in Predicting Mortality in Transthyretin Amyloidosis

“…Numerous prospective studies have demonstrated the ability of various quality of life (QOL) scores to predict mortality in patients with heart failure [41-43], but often employ lengthy scoring systems. Some of these studies have been criticized for not adjusting for covariates [42].…”

Social Capital as a Predictor of Quality of Life: The Czech Experience

“…The second level is formed by quality of life, which is an influencing variable and as such a predictor of some influenced variables. Quality of life is a predictor of health [11][12][13], depression [14] and the outcome of the Czech presidential election [15]. Predictors of quality of life need to be distinguished from factors supporting its improvement [16].…”

Impact of hospitalisation on health-related quality of life in patients with chronic heart failure

“…In others words, using the QALY model as the measure of effectiveness in economic evaluations implies missing temporary changes in utility, particularly when these changes are due to disease-related events. For instance, when having access to two consecutive utility measurements with the same value – one before and other after a particular event –, using the QALY model leads to an implicit assumption that the utility of that same patient was constant throughout both time points and that the event that took place had no influence in the QoL of that patient, even though this assumption is unlikely to hold in an event such as a hospitalisation [ 10 , 11 ]. In this sense, empirical identification of the direct impact of hospitalisation on the change in utility could provide an interpretation for some of the unexplained variance in QoL responses in clinical practice and clinical trials, as well as it may provide assistance to researchers in designing trials aimed at assessing patient-reported outcomes.…”