Health Status Identifies Heart Failure Outpatients at Risk for Hospitalization or Death

Abstract

A low KCCQ score is an independent predictor of poor prognosis in outpatients with HF.

Poor Health-Related Quality of Life Is a Predictor of Early, But Not Late, Cardiac Events After Percutaneous Coronary Intervention

“…This is in contrast to several other studies of patients with acute coronary syndrome or heart failure that found poor HRQL to be a predictor of poor prognosis and hospitalization, [3][4][5][6][7][8] although it should be noted that Rumsfeld and colleagues 4 found that the Physical Component Summary but not the Mental Component Summary of the Short-Form Health Survey-36 was associated with increased risk of mortality. The follow-up in these studies ranged from 6 months 4,8 to 36 months, 7 but all studies evaluated the respective endpoints at one timepoint and not at two time-points, as in the current study.…”

“…HRQL assessment may also serve as a valuable factor in risk-stratification in research and clinical practice and may help guide clinical decision-management, given the discrepancies found between physician-rated and patient-rated functional status. 2 However, despite studies showing that impaired HRQL comprises a risk factor for mortality and hospitalization in patients with established coronary artery disease (CAD) 3,4 and heart failure, [5][6][7][8] independent of traditional biomedical risk factors, it is not yet standard procedure to assess HRQL in research and clinical practice. 9 Also, the effect of HRQL on adverse clinical outcome has not yet been evaluated in a pure sample of patients treated with percutaneous coronary intervention (PCI).…”

Symptom Burden, Depression, and Spiritual Well-Being: A Comparison of Heart Failure and Advanced Cancer Patients

“…We used a KCCQ cutoff of 50 since a score of <50 among chronic heart failure outpatients was associated with more than twice the increased risk of hospitalization or death in the following year. 32 The first analysis provided an overall comparison of number of symptoms, depression score, and spiritual well-being between the two patient populations. To test whether ejection fraction was associated with symptom burden, depression symptoms, and spiritual well-being, we then divided the heart failure group into three categories, ejection fraction ≤ 30, between 30 and 50, and ≥50.…”

“…Our study found that heart failure-specific health status, as measured by the KCCQ, better reflected the burden of illness on patients' symptoms, mood, and spiritual well-being than patients' measured ejection fractions. The instrument we used to measure heart failure-specific health status, the KCCQ, is a useful marker of prognosis 32 and can monitor changes in clinical status over time. 31 This study demonstrates its use in identifying disease burden in three palliative care domains.…”

“…30,31 The overall score (range, 0-100; higher score indicates better heart failurerelated health status) predicts future cardiovascular mortality and rehospitalization. 32 Cronbach's alpha ranges from 0.78-0.90 for the subscales making up the overall score. The most recent ejection fraction at the time of study participation was obtained by medical record review.…”