Prognostic value of health-related quality of life in elderly patients hospitalized with heart failure
Received 13 January 2019
Accepted for publication 30 April 2019
Published 22 May 2019 Volume 2019:14 Pages 935—945
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Dr Richard Walker
Predrag Erceg,1,2 Nebojsa Despotovic,1,2 Dragoslav P Milosevic,1,2 Ivan Soldatovic,1 Gordana Mihajlovic,1,2 Vladan Vukcevic,1,3 Predrag Mitrovic,1,3 Natasa Markovic-Nikolic,1,4 Milica Micovic,2 Dragica Mitrovic,5 Mladen Davidovic1
1Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 2Clinical Department of Geriatrics, “Zvezdara” University Hospital, Belgrade, Serbia; 3Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia; 4Clinical Department of Cardiology, “Zvezdara” University Hospital, Belgrade, Serbia; 5Department of Physical Medicine and Rehabilitation, “Zvezdara” University Hospital, Belgrade, Serbia
Purpose: Previous research has shown that poor health-related quality of life (HRQOL) is associated with adverse long-term prognosis in patients with heart failure (HF); however, there have been inconsistencies among studies and not all of them confirmed the prognostic value of HRQOL. In addition, few studies involved elderly patients and most focused on all-cause mortality and HF-related hospitalization as outcomes. The aim of our study was to determine whether HRQOL is a predictor and an independent predictor of long-term cardiac mortality, all-cause mortality, and HF-related rehospitalization in elderly patients hospitalized with HF.
Patients and methods: This prospective observational study included 200 elderly patients hospitalized with HF in Serbia. HRQOL was measured using the Minnesota Living with Heart Failure questionnaire (MLHFQ). The median follow-up period was 28 months. The primary outcome was cardiac mortality, and all-cause mortality and HF-related rehospitalization were secondary outcomes. Survival analysis was conducted using the Kaplan–Meier method and Cox-proportional hazards regression.
Results: Subjects with poor HRQOL (higher than the median MLHFQ score) had a higher probability of cardiac mortality (P=0.029) and HF-related rehospitalization (P=0.001) during long-term follow-up. Poor HRQOL was an independent predictor of cardiac mortality (HR: 2.051, 95% CI: 1.260–3.339, P=0.004), all-cause mortality (HR: 1.620, 95% CI: 1.076–2.438, P=0.021), and HF-related rehospitalization (HR: 2.040, 95% CI: 1.290–3.227, P=0.002).
Conclusion: HRQOL is an independent predictor of long-term cardiac mortality in elderly patients hospitalized with HF. It also independently predicts all-cause mortality and HF-related rehospitalization. HRQOL could be used as a complementary clinical predictive tool in this patient population.
Keywords: aged, heart disease, self-perception of health, prognosis
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