 |
|
Health-Related Quality of Life as a Predictor of Hospital Readmission and Death Among Patients With Heart Failure
Fernando Rodríguez-Artalejo, MD, PhD;
Pilar Guallar-Castillón, MD, PhD;
Carlos Rodríguez Pascual, MD, PhD;
Carmen Montoto Otero, MD;
Ana Ortega Montes, MD;
Adoración Nieto García, MD, PhD;
Pedro Conthe, MD, PhD;
Maite Olcoz Chiva, MD;
José R. Banegas, MD, PhD;
Manuel Conde Herrera, MD, PhD
Arch Intern Med. 2005;165:1274-1279.
Background We sought to examine the relationship between health-related quality of life (HRQL) and a first emergency rehospitalization and mortality in patients with heart failure (HF) having a wide variation in ventricular ejection fraction and functional status.
Methods Prospective study conducted with 394 patients admitted for HF-related emergencies at 4 Spanish hospitals. Baseline HRQL was measured with a generic questionnaire, the Medical Outcomes Study 36-item Short Form Survey (SF-36), and with an HF-specific instrument, the Minnesota Living With Heart Failure (MLWHF) questionnaire. Cox proportional hazards models were used to calculate hazard ratios (HRs) for hospitalization and death on the basis of HRQL scores.
Results During a median follow-up of approximately 6 months, 138 patients (35.0%) underwent a first emergency rehospitalization and 70 (17.8%) died. After adjustment for biomedical, psychosocial, and health care variables, the frequency of hospital readmission was higher in patients with worse scores on the SF-36 physical functioning (HR, 1.65; 95% confidence interval [CI], 1.11-2.44; P = .01), general health (HR, 1.73; 95% CI, 1.19-2.52; P = .003), and mental health (HR, 1.65; 95% CI, 1.10-2.47; P = .02) subscales. Results were similar for the mortality end point. For the MLWHF questionnaire, worse overall and worse physical and emotional summary scores were associated with higher mortality.
Conclusions Worse HRQL is associated with hospital readmission and death in patients with HF. The magnitude of this association, for both physical and mental HRQL components, is comparable to that for other well-known predictors of hospital readmission and death, such as personal history of diabetes, previous hospitalizations, and treatment with angiotensin-converting enzyme inhibitors.
Author Affiliations: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid (Drs Rodríguez-Artalejo, Guallar-Castillón, and Banegas); Division of Geriatrics, Hospital de Meixoeiro, Vigo (Drs Rodríguez Pascual, Ortega Montes, and Olcoz Chiva); Service of Internal Medicine I, Hospital General Universitario Gregorio Marañón, Madrid (Drs Montoto Otero and Conthe); Department of Social and Health Sciences, Universidad de Sevilla, Seville (Drs Nieto García and Conde Herrera); and Service of Preventive Medicine, Hospital Universitario Virgen del Rocío, Seville (Dr Conde Herrera), Spain.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Health-Related Quality of Life After Cardiac Surgery
Gorman Koch et al.
SEMIN CARDIOTHORAC VASC ANESTH 2008;12:203-217.
ABSTRACT
Statistical Models and Patient Predictors of Readmission for Heart Failure: A Systematic Review
Ross et al.
Arch Intern Med 2008;168:1371-1386.
ABSTRACT
| FULL TEXT
Patterns and Predictors of Early Hospital Readmission in Patients With Congestive Heart Failure
Hallerbach et al.
American Journal of Medical Quality 2008;23:18-23.
ABSTRACT
Poor Health-Related Quality of Life Is a Predictor of Early, But Not Late, Cardiac Events After Percutaneous Coronary Intervention
Pedersen et al.
Psychosomatics 2007;48:331-337.
ABSTRACT
| FULL TEXT
Physical functioning and mental well-being in association with health outcome in patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial II
Piotrowicz et al.
Eur Heart J 2007;28:601-607.
ABSTRACT
| FULL TEXT
The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures: a report from the Euro Heart Survey on Coronary Revascularisation
Lenzen et al.
Heart 2007;93:339-344.
ABSTRACT
| FULL TEXT
Effect of Functional Health-Related Quality of Life on Long-Term Survival After Cardiac Surgery
Koch et al.
Circulation 2007;115:692-699.
ABSTRACT
| FULL TEXT
Health Status Identifies Heart Failure Outpatients at Risk for Hospitalization or Death
Heidenreich et al.
J Am Coll Cardiol 2006;47:752-756.
ABSTRACT
| FULL TEXT
|
