Quality of life monitoring in ambulatory heart failure patients: temporal changes and prognostic value

Lupón, J.; Gastelurrutia, P.; de Antonio, M.; González, B.; Cano, L.ía.; Cabanes, R.; Urrutia, A.ín.; Díez, C.; Coll, R.ón.; Altimir, S.; Bayes-Genis, A.; Lupón, J; Gastelurrutia, P; de Antonio, M; González, B; Cano, L.ía; Cabanes, R; Urrutia, A.ín; Díez, C; Coll, R.ón; Altimir, S; Bayes-Genis, A

doi:10.1093/eurjhf/hfs133

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Quality of life monitoring in ambulatory heart failure patients: temporal changes and prognostic value

Lupón, J.; Gastelurrutia, P.; de Antonio, M.; González, B.; Cano, L.ía.; Cabanes, R.; Urrutia, A.ín.; Díez, C.; Coll, R.ón.; Altimir, S.; Bayes-Genis, A.

European Journal of Heart Failure 15(1): 103-109

2013

ISSN/ISBN: 1879-0844

PMID: 22923075

DOI: 10.1093/eurjhf/hfs133
Accession: 055310582

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Summary

Heart failure (HF) is a chronic condition that typically affects a patient's quality of life (QoL). Little is known about long-term QoL monitoring in HF. This study aimed to evaluate the temporal changes and prognostic value of QoL assessment in a real-life cohort of HF patients. The Minnesota Living with Heart Failure Questionnaire was used to monitor QoL at baseline and at 1, 3, and 5 years for 1151 consecutive patients {71.7% men, median age 69 years [25th-75th percentiles (P(25)-P(75)) 59-76]} in an HF unit. Follow-up for prognosis assessment was extended to 6 years. The number of answered questionnaires was 1151 at baseline, 746 at 1 year, 268 at 3 years, and 240 at 5 years. QoL scores showed a steep decrease (indicating QoL improvement) during the first year [29 (P(25)-P(75) 16-43) at baseline vs. 15 (P(25)-P(75) 8-27) at 1 year, P < 0.001], which was tempered, yet significant up to 5 years [12 (P(25)-P(75) 7-23) at 3 years vs. 10 (P(25)-P(75) 5-21) at 5 years, P = 0.012]. We recorded 457 deaths during follow-up. In a comprehensive multivariable Cox regression analysis, baseline QoL remained a significant prognosticator during follow-up [hazard ratio (HR)(Cox) for death 1.012, 95% confidence interval 1.006-1.018, P < 0.001]. QoL monitoring showed that a score increase ≥10% between consecutive assessments stratified high-risk patients within the next 12 months (P = 0.008). Both baseline and follow-up QoL monitoring were useful for patient risk stratification in a real-life HF cohort. Worse QoL may warn of a worse prognosis. Widespread QoL monitoring in routine clinical practice is recommended.