Aims: To analyse measures of clinical data, functional capacity, left ventricu lar function and neurohormonal activation for the ability to predict mortality a nd morbidity in patients after a hospitalisation for hear...Aims: To analyse measures of clinical data, functional capacity, left ventricu lar function and neurohormonal activation for the ability to predict mortality a nd morbidity in patients after a hospitalisation for heart failure. Methods: In a prospective study, patients 60 years or above with systolic heart failure NYHA II-IV were followed for at least 18 months. At study start, a physical examina tion, echocardiography, blood samples and measurements of quality of life(QoL) b y Nottingham Health Profile were obtained. Data on mortality and readmission rat es were collected. Results: 208 patients, 58%men, with a mean age of 76 years, and an ejection fraction of 0.34 were included and followed for a mean of 1122 d ays. In all, 74(36%) patients died and 171(82%) were readmitted. By univariate analysis, readmissions were predicted by poor QoL(169±118 vs. 83±100, p< 0.00 1), age, creatinine, haemoglobin(p< 0.01 all) and diabetes(p< 0.1). By multivari ate analyses, QoL at study start was the only independent predictor of readmissi ons(χ2=25.2, p< 0.001). Mortality was univariately associated with QoL(183±117 vs. 142±115, p< 0.05) and in multivariate analyses to traditional variables: a ge, male gender, systolic function, BNP and serum creatinine(χ2=48.9, p< 0.001) . Conclusions: Measurements representing different aspects of the heart failure syndrome can easily be obtained to stratify long-term risks of mortality and mo rbidity in hospitalised heart failure patients. Poor QoL was a univariate predic tor for mortality and a strong multivariate predictor for the important outcome of readmission, pointing to the need for a simple assessment of QoL.展开更多
文摘Aims: To analyse measures of clinical data, functional capacity, left ventricu lar function and neurohormonal activation for the ability to predict mortality a nd morbidity in patients after a hospitalisation for heart failure. Methods: In a prospective study, patients 60 years or above with systolic heart failure NYHA II-IV were followed for at least 18 months. At study start, a physical examina tion, echocardiography, blood samples and measurements of quality of life(QoL) b y Nottingham Health Profile were obtained. Data on mortality and readmission rat es were collected. Results: 208 patients, 58%men, with a mean age of 76 years, and an ejection fraction of 0.34 were included and followed for a mean of 1122 d ays. In all, 74(36%) patients died and 171(82%) were readmitted. By univariate analysis, readmissions were predicted by poor QoL(169±118 vs. 83±100, p< 0.00 1), age, creatinine, haemoglobin(p< 0.01 all) and diabetes(p< 0.1). By multivari ate analyses, QoL at study start was the only independent predictor of readmissi ons(χ2=25.2, p< 0.001). Mortality was univariately associated with QoL(183±117 vs. 142±115, p< 0.05) and in multivariate analyses to traditional variables: a ge, male gender, systolic function, BNP and serum creatinine(χ2=48.9, p< 0.001) . Conclusions: Measurements representing different aspects of the heart failure syndrome can easily be obtained to stratify long-term risks of mortality and mo rbidity in hospitalised heart failure patients. Poor QoL was a univariate predic tor for mortality and a strong multivariate predictor for the important outcome of readmission, pointing to the need for a simple assessment of QoL.
