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The clinical course of health status and association with outcomes in patients hospitalized for heart failure: Insights from ASCEND-HF
Ambrosy, Andrew P. Hernandez, Adrian F. Armstrong, Paul W. Butler, Javed Dunning, Allison Ezekowitz, Justin A. Felker, G. Michael Greene, Stephen J. Kaul, Padma McMurray, John J. V.
Ambrosy, Andrew P.
Hernandez, Adrian F.
Armstrong, Paul W.
Butler, Javed
Dunning, Allison
Ezekowitz, Justin A.
Felker, G. Michael
Greene, Stephen J.
Kaul, Padma
McMurray, John J. V.
Author
Ambrosy, Andrew P.
Hernandez, Adrian F.
Armstrong, Paul W.
Butler, Javed
Dunning, Allison
Ezekowitz, Justin A.
Felker, G. Michael
Greene, Stephen J.
Kaul, Padma
McMurray, John J. V.
Metra, Marco
O'Connor, Christopher M.
Reed, Shelby D.
Schulte, Phillip J.
Starling, Randall C.
Tang, W. H. Wilson
Voors, Adriaan A.
Mentz, Robert J.
Hernandez, Adrian F.
Armstrong, Paul W.
Butler, Javed
Dunning, Allison
Ezekowitz, Justin A.
Felker, G. Michael
Greene, Stephen J.
Kaul, Padma
McMurray, John J. V.
Metra, Marco
O'Connor, Christopher M.
Reed, Shelby D.
Schulte, Phillip J.
Starling, Randall C.
Tang, W. H. Wilson
Voors, Adriaan A.
Mentz, Robert J.
Abstract
Aims: A longitudinal and comprehensive analysis of health-related quality of life ( HRQOL ) was performed during hospitalization for heart failure ( HF ) or soon after discharge. Methods and results: A post-hoc analysis was performed of the ASCEND-HF trial. The EuroQOL five dimensions questionnaire ( EQ-5D ) was administered to study participants at baseline, 24 h, discharge/day 10, and day 30. EQ-5D includes functional dimensions mapped to corresponding utility scores ( i.e. 0 = death and 1 = perfect health ), and a visual analogue scale ( VAS ) ranging from 0 ( i.e. ‘worst imaginable health state’ ) to 100 ( i.e. ‘best imaginable health state’ ). The association between baseline and discharge EQ-5D measurements and subsequent clinical outcomes including death and rehospitalization were assessed using multivariable logistic regression and Cox proportional hazards regression. A total of 6943 patients ( 97% ) had complete EQ-5D data at baseline. Mapped utility and VAS scores ( mean ± SD ) increased over time, respectively, from 0.56 ± 0.23 and 45 ± 22 at baseline to 0.67 ± 0.26 and 58 ± 22 at 24 h and to 0.79 ± 0.20 and 68 ± 22 at discharge, and remained stable at day 30. Lower mapped utility scores at baseline [odds ratio ( OR ) per 0.1 decrease in utility score 1.03, 95% confidence interval ( CI ) 1.00–1.06] and discharge ( OR 1.10, 95% CI 1.05–1.15 ) and VAS scores at baseline ( OR per 10 point decrease 1.05, 95% CI 1.01–1.09 ) were significantly associated with increased risk of 30-day all-cause death or HF rehospitalization. Conclusions: Patients hospitalized for HF had severely impaired health status at baseline and, although this improved substantially during admission, health status remained abnormal at discharge.
Keywords
Date
2016
Type
Journal article
Journal
European Journal of Heart Failure
Book
Volume
18
Issue
3
Page Range
306-313
Article Number
ACU Department
Collections
Relation URI
DOI
Source URL
Event URL
Open Access Status
License
File Access
Controlled