Improvement in health-related quality of life after hospitalization predicts event-free survival in patients with advanced heart failure
Open accessAbstract
Background Health-related quality of life (HRQOL) is a major clinical outcome for heart failure (HF) patients. We aimed to determine the frequency, durability, and prognostic significance of improved HRQOL after hospitalization for decompensated HF.Methods and results We analyzed HRQOL, measured serially using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), for 425 patients who survived to discharge in a multicenter randomized clinical trial of pulmonary artery catheter versus clinical assessment to guide therapy for patients with advanced HF. All patients enrolled had 1 or more prior HF hospitalizations or chronic high diuretic doses and 1 or more symptom and 1 sign of fluid overload at admission. Improvement, defined as a decrease of more than 5 points in MLHFQ total score, occurred in 68% of patients by 1 month and stabilized. The degree of 1-month improvement differed (P < .0001 group x time interaction) between 6-month survivors and non-survivors. In a Cox regression model, after adjustment for traditional risk factors for HF morbidity and mortality, improvement in HRQOL by 1 month compared to worsening at 1 month or no change predicted time to subsequent event-free survival (P=.013).Conclusions In patients hospitalized with severe HF decompensation, HRQOL is seriously impaired but improves substantially within 1 month for most patients and remains improved for 6 months. Patients for whom HRQOL does not improve by 1 month after hospital admission merit specific attention both to improve HRQOL and to address high risk for poor event-free survival.
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The MLHFQ is frequently used in CHF due to its ease and familiarity, and it predicts event-free survival following CHF decompensation with utility in identifying changes in the patient's quality of life and outcomes.
“It is frequently used in CHF due to its ease and familiarity, 111 and it predicts event‐free survival following CHF decompensation with utility in identifying changes in the patient's QoL and outcomes. 112”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [112]
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“It is frequently used in CHF due to its ease and familiarity,(111) and it predicts event-free survival following CHF decompensation with utility in identifying changes in the patient’s QoL and outcomes.(112) The KCCQ quantifies health status with a higher score indicating better health predictive of hospitalization an…”
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- Authors
- Moser, D. K., Yamokoski, L., Sun, J. L., Conway, G. A., Hartman, K. A., Graziano, J. A., Binanay, C., & Stevenson, L. W.
- Affiliations
- University of Kentucky (US)
- The Ohio State University (US)
- Duke Medical Center (US)
- University of Cincinnati (US)
- Mayo Clinic (US)
- University of Minnesota (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Moser, Debra K.
- Venue
- Journal of Cardiac Failure
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 15
- Issue
- 9
- Pages
- 763-769
- ISSN
- 1071-9164 (ISSN-L)
- PMC
- PMC2772831
- OpenAlex
- W2001709913
- Cited by
- 96
- References
- 31
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 6 · 2020: 9 · 2019: 4 · 2018: 5 · 2017: 5 · 2016: 3 · 2015: 9 · 2014: 6 · 2013: 13 · 2012: 10
- FWCI
- 3.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Cardiac Failure (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01hv098177-001)
- National Heart, Lung, and Blood Institute (N01 HV098177)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- health-related quality of life, advanced heart failure, acute decompensated heart failure, event-free survival, prognostic factors, Minnesota Living with Heart Failure Questionnaire, pulmonary artery catheter, fluid overload, hospitalization outcomes
- MeSH terms
- Adult, Aged, Female, Follow-Up Studies, Health Status, Heart Failure, Hospitalization, Humans, Male, Middle Aged, Predictive Value of Tests, Quality of Life, Risk Factors, Cohort Studies, Survival Rate, Disease-Free Survival
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