Swipe om te navigeren naar een ander artikel
Health status measures are widely recognized as providing substantial information on heart failure (HF) patients conditions and prognosis, but they are not included in the data routinely collected. The aim of the study was to assess in a prospective cohort of HF patients, the independent prognostic value of health status measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ) on mortality and hospital admissions over a period of 3.3 years.
Eighty-three Italian cardiology centers included all their patients randomized in the GISSI-HF trial in an observational outcome study where the KCCQ was administered at baseline by nursing personnel. A total of 1,465 outpatients with chronic HF, NYHA classes II–III, with coronary and non-coronary etiology were included and followed up for mortality and admissions.
The effect of baseline perception of health status on mortality and all causes hospitalizations was explored with Cox proportional hazard regression models progressively adjusted for several variables. When stratified according to pre-defined criteria, lower values of KCCQ scores (<25) as compared with best scores (>75) were predictive of mortality (1.85; 95 % CI 1.16–2.95) but not of hospital admissions risk (p for trend significant for mortality with decreasing scores). Lower KCCQ scores discriminated the risk also within the NYHA II and III classes.
KCCQ scores provide a clinically important and statistically robust independent prognostic information on hard outcome endpoints of HF patients on the top of the clinical scores. It is suggested that KCCQ should become a routine component of the patients care and of prognostic profiles.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Konstam, V., Salem, D., Pouleur, H., Kostis, J., Gorkin, L., Shumaker, S., et al. (1996). Baseline quality of life as a predictor of mortality and hospitalization in 5.025 patients with congestive heart failure. SOLVD Investigations. Studies of Left Ventricular Dysfunction Investigators. American Journal of Cardiology, 78(8), 890–895. PubMedCrossRef
Rodríguez-Artalejo, F., Guallar-Castillón, P., Pascual, C. R., Otero, C. M., Montes, A. O., Garcia, A. N., et al. (2005). Health-related quality of life as a predictor of hospital readmission and death among patients with heart failure. Archives of Internal Medicine, 165(11), 1274–1279. PubMedCrossRef
Heidenreich, P. A., Spertus, J. A., Jones, P. G., Weintraub, W. S., Rumsfeld, J. S., Rathore, S. S., et al. (2006). Health status identifies heart failure patients at risk for hospitalization or death. Journal of American College of Cardiology, 47(4), 752–756. CrossRef
Chan, P. S., Soto, G., Jones, P. G., Brahmajee, K., Nallamothu, K., Zhang, Z., et al. (2009). Patient health status and costs in heart failure. Insights from the Eplenorone post-acute myocardial infarction Heart Failure Efficacy and Survival Study (EPHESUS). Circulation, 119(3), 398–407. PubMedCrossRef
Mommersteeg, P. M. C., Denollet, J., Spertus, J., & Pedersen, S. S. (2009). Health status as a risk factor in cardiovascular disease: A systematic review of current evidences. American Heart Journal, 157(2), 201–218. CrossRef
Parissis, J. T., Nikolau, M., Farmakis, D., Paraskevaidis, I. A., Bistola, V., Venetsanou, K., et al. (2009). Self assessment of health status is associated with inflammatory activation and predicts long term outcomes in chronic heart failure. Heart Failure Reviews, 11(4), 163–169.
Investigators, G. I. S. S. I.-H. F., Tavazzi, L., Maggioni, A. P., Marchioli, R., Barlera, S., Franzosi, M. G., et al. (2008). Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): A randomised, double-blind, placebo-controlled trial. The Lancet, 372(9645), 1223–1230. CrossRef
Miani, D., Rozbowsky, P., Gregori, D., Pilotto, L., Albanese, M. C., Fresco, C., et al. (2003). The Kansas City Cardiomyopathy Questionnaire: Italian translation and validation. Italian Heart Journal, 4(9), 620–626. PubMed
Tavazzi, L., Tognoni, G., Franzosi, M. G., Latini, R., Maggioni, A. P. M., Marchioli, R., et al. (2004). Rationale and design of the GISSI heart failure trial: A large trial to assess the effects of n-3 polyunsaturated fatty acids and rosuvastatin in symptomatic congestive heart failure. The European Journal of Heart Failure, 6(5), 635–641. CrossRef
Hosmer, D. W., & Lemeshow, S. (1989). Applied logistic regression. New York: Wiley.
Rahimi, K., Malholtra, A., Banning, A. P., & Jenkinson, C. (2010). Outcome selection and role of patients reported outcomes in contemporary cardiovascular trials: Systematic review. BMJ, 314, c5750. doi: 10.1136/bmj.c507.
McAlister, F. A., Stewart, S., Ferrua, S., & McMurray, J. J. (2004). Multidisciplinary strategies for the management of heart failure patients at high risk for admission: A systematic review of randomized trials. Journal of the American College of Cardiology, 44(4), 810–819. PubMed
Investigators, Gesica. (2005). Randomised trial of telephone intervention in chronic heart failure: DIAL trial. British Medical Journal, 331(7514), 425–429. CrossRef
- Should patients perception of health status be integrated in the prognostic assessment of heart failure patients? A prospective study
Paola Di Giulio
Network of Nurses of GISSI-HF
- Springer International Publishing