American heart journal plus : cardiology research and practice · 2022
Predictors and outcomes of quality of life in elderly patients with heart failure.
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Wang Nelson, Hales Susan, Gallagher Robyn, Tofler Geoffrey
Аннотация
STUDY OBJECTIVE: This study aims to identify predictors of health related quality of life (HRQoL) among patients with heart failure (HF) and assess whether HRQoL was a predictor of rehospitalisation and mortality, and if age influenced the findings.
DESIGN: Observational cohort study.
SETTING: Seven hospitals in the Northern Sydney Local Health District, Sydney, Australia.
PARTICIPANTS: Community dwelling patients who completed a Minnesota Living with HF questionnaire (MLHFQ) within 30 days of discharge after a HF hospitalisation.
MAIN OUTCOME MEASURE: Multivariable linear regression models were used to identify predictors of MLHFQ scores (higher score = worse HRQoL) and adjusted Cox regression models to assess the impact of MLHFQ scores on one-year rehospitalisation and mortality. Separate analyses were conducted for those aged ≤80 or >80 years.
RESULTS: 1911 patients of mean age 79 years (57 % aged >80 years) were included in this analysis. Among those aged ≤80 years; younger age, lower haemoglobin and presenting symptoms at hospitalisation of exertional dyspnoea, peripheral oedema and fatigue were predictors of worse post-discharge MLHFQ scores. In patients aged >80 years, living alone, chronic kidney disease, exertional dyspnoea and peripheral oedema were predictors of worse MLHFQ scores. Worse MLHFQ scores predicted one-year HF readmissions in those aged >80 years (HR 1.22, 95 % CI 1.07-1.37) but not those aged ≤80 years (HR 0.90 95 % CI 0.71-1.10).
CONCLUSIONS: In-hospital predictors can be identified for worse HRQoL post-discharge for HF. These vary according to age, and should be addressed prior to discharge.
DESIGN: Observational cohort study.
SETTING: Seven hospitals in the Northern Sydney Local Health District, Sydney, Australia.
PARTICIPANTS: Community dwelling patients who completed a Minnesota Living with HF questionnaire (MLHFQ) within 30 days of discharge after a HF hospitalisation.
MAIN OUTCOME MEASURE: Multivariable linear regression models were used to identify predictors of MLHFQ scores (higher score = worse HRQoL) and adjusted Cox regression models to assess the impact of MLHFQ scores on one-year rehospitalisation and mortality. Separate analyses were conducted for those aged ≤80 or >80 years.
RESULTS: 1911 patients of mean age 79 years (57 % aged >80 years) were included in this analysis. Among those aged ≤80 years; younger age, lower haemoglobin and presenting symptoms at hospitalisation of exertional dyspnoea, peripheral oedema and fatigue were predictors of worse post-discharge MLHFQ scores. In patients aged >80 years, living alone, chronic kidney disease, exertional dyspnoea and peripheral oedema were predictors of worse MLHFQ scores. Worse MLHFQ scores predicted one-year HF readmissions in those aged >80 years (HR 1.22, 95 % CI 1.07-1.37) but not those aged ≤80 years (HR 0.90 95 % CI 0.71-1.10).
CONCLUSIONS: In-hospital predictors can be identified for worse HRQoL post-discharge for HF. These vary according to age, and should be addressed prior to discharge.