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Patients' Self-Assessed Functional Status in Heart Failure by New York Heart Association Class: A Prognostic Predictor of Hospitalizations, Quality of Life and Death
BACKGROUND: Clinician-assigned New York Heart Association (NYHA) class is an established predictor of outcomes in heart failure. This study aims to test whether patients' self-assessment of functional status by NYHA class predicts hospital admissions, quality of life, and mortality. METHODS AND...
Autores principales: | , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Churchill Livingstone
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817782/ https://www.ncbi.nlm.nih.gov/pubmed/20142027 http://dx.doi.org/10.1016/j.cardfail.2009.08.010 |
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author | Holland, Richard Rechel, Boika Stepien, Karolina Harvey, Ian Brooksby, Iain |
author_facet | Holland, Richard Rechel, Boika Stepien, Karolina Harvey, Ian Brooksby, Iain |
author_sort | Holland, Richard |
collection | PubMed |
description | BACKGROUND: Clinician-assigned New York Heart Association (NYHA) class is an established predictor of outcomes in heart failure. This study aims to test whether patients' self-assessment of functional status by NYHA class predicts hospital admissions, quality of life, and mortality. METHODS AND RESULTS: This was an observational study within a randomized controlled trial. A total of 293 adult patients diagnosed with heart failure were recruited after an emergency admission at 3 acute hospitals in Norfolk, UK. Outcome measures included number of emergency admissions over 6 months, self-assessed quality of life measured with the Minnesota Living with Heart Failure questionnaire (MLHFQ) and EQ-5D at 6 months, and deaths up to 20 months' follow-up. Patients were grouped into 3 NYHA groups (I/II, III, and IV) based on patients' self-assigned NYHA class (SA-NYHA). A Poisson model indicated an increased readmission rate associated with higher SA-NYHA class (adjusted rate ratio 1.21; 95% CI 1.04–1.41; P = .02). Higher SA-NYHA class at baseline predicted worse quality of life at 6 months' follow-up (P = .002 for MLHFQ; P = .047 for EQ-5D), and was associated with higher mortality rate (adjusted hazard ratio 1.84; 95% CI 1.10–3.06; P = .02). CONCLUSIONS: SA-NYHA class is predictive of hospitalization, quality of life, and mortality among patients with heart failure. |
format | Text |
id | pubmed-2817782 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Churchill Livingstone |
record_format | MEDLINE/PubMed |
spelling | pubmed-28177822010-03-02 Patients' Self-Assessed Functional Status in Heart Failure by New York Heart Association Class: A Prognostic Predictor of Hospitalizations, Quality of Life and Death Holland, Richard Rechel, Boika Stepien, Karolina Harvey, Ian Brooksby, Iain J Card Fail Clinical Investigation BACKGROUND: Clinician-assigned New York Heart Association (NYHA) class is an established predictor of outcomes in heart failure. This study aims to test whether patients' self-assessment of functional status by NYHA class predicts hospital admissions, quality of life, and mortality. METHODS AND RESULTS: This was an observational study within a randomized controlled trial. A total of 293 adult patients diagnosed with heart failure were recruited after an emergency admission at 3 acute hospitals in Norfolk, UK. Outcome measures included number of emergency admissions over 6 months, self-assessed quality of life measured with the Minnesota Living with Heart Failure questionnaire (MLHFQ) and EQ-5D at 6 months, and deaths up to 20 months' follow-up. Patients were grouped into 3 NYHA groups (I/II, III, and IV) based on patients' self-assigned NYHA class (SA-NYHA). A Poisson model indicated an increased readmission rate associated with higher SA-NYHA class (adjusted rate ratio 1.21; 95% CI 1.04–1.41; P = .02). Higher SA-NYHA class at baseline predicted worse quality of life at 6 months' follow-up (P = .002 for MLHFQ; P = .047 for EQ-5D), and was associated with higher mortality rate (adjusted hazard ratio 1.84; 95% CI 1.10–3.06; P = .02). CONCLUSIONS: SA-NYHA class is predictive of hospitalization, quality of life, and mortality among patients with heart failure. Churchill Livingstone 2010-02 /pmc/articles/PMC2817782/ /pubmed/20142027 http://dx.doi.org/10.1016/j.cardfail.2009.08.010 Text en © 2010 Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/3.0/ Open Access under CC BY-NC-ND 3.0 (https://creativecommons.org/licenses/by-nc-nd/3.0/) license |
spellingShingle | Clinical Investigation Holland, Richard Rechel, Boika Stepien, Karolina Harvey, Ian Brooksby, Iain Patients' Self-Assessed Functional Status in Heart Failure by New York Heart Association Class: A Prognostic Predictor of Hospitalizations, Quality of Life and Death |
title | Patients' Self-Assessed Functional Status in Heart Failure by New York Heart Association Class: A Prognostic Predictor of Hospitalizations, Quality of Life and Death |
title_full | Patients' Self-Assessed Functional Status in Heart Failure by New York Heart Association Class: A Prognostic Predictor of Hospitalizations, Quality of Life and Death |
title_fullStr | Patients' Self-Assessed Functional Status in Heart Failure by New York Heart Association Class: A Prognostic Predictor of Hospitalizations, Quality of Life and Death |
title_full_unstemmed | Patients' Self-Assessed Functional Status in Heart Failure by New York Heart Association Class: A Prognostic Predictor of Hospitalizations, Quality of Life and Death |
title_short | Patients' Self-Assessed Functional Status in Heart Failure by New York Heart Association Class: A Prognostic Predictor of Hospitalizations, Quality of Life and Death |
title_sort | patients' self-assessed functional status in heart failure by new york heart association class: a prognostic predictor of hospitalizations, quality of life and death |
topic | Clinical Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817782/ https://www.ncbi.nlm.nih.gov/pubmed/20142027 http://dx.doi.org/10.1016/j.cardfail.2009.08.010 |
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