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Health status identifies heart failure outpatients at risk for hospitalization or death.

Abstract：

OBJECTIVES:We tested the hypothesis that one health status measure, the Kansas City Cardiomyopathy Questionnaire (KCCQ), provides prognostic information independent of other clinical data in outpatients with heart failure (HF). BACKGROUND:Health status measures are used to describe a patient's clinical condition and have been shown to predict mortality in some populations. Their prognostic value may be particularly useful among patients with HF for identifying candidates for disease management in whom increased care may reduce hospitalizations and prevent death. METHODS:We evaluated 505 HF patients from 13 outpatient clinics who had an ejection fraction <40% using the KCCQ summary score. Proportional hazards regression was used to evaluate the association between the KCCQ summary score (range, 0 to 100; higher scores indicate better health status) and the primary outcome of death or HF admission, adjusting for baseline patient characteristics, 6-min walk distance, and B-type natriuretic peptide (BNP). RESULTS:The mean age was 61 years, 76% of patients were male, 51% had an ischemic HF etiology, and 5% were New York Heart Association functional class IV. At 12 months, among the 9% of patients with a KCCQ score <25, 37% had been admitted for HF and 20% had died, compared with 7% (HF admissions) and 5% (death) of those with a KCCQ score > or =75 (33% of patients, p < 0.0001 for both comparisons). In sequential multivariable models adjusting for clinical variables, 6-min walk, and BNP levels, the KCCQ score remained significantly associated with survival free of HF hospitalization. CONCLUSIONS:A low KCCQ score is an independent predictor of poor prognosis in outpatients with HF.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Heidenreich PA,Spertus JA,Jones PG,Weintraub WS,Rumsfeld JS,Rathore SS,Peterson ED,Masoudi FA,Krumholz HM,Havranek EP,Conard MW,Williams RE,Cardiovascular Outcomes Research Consortium.

doi

10.1016/j.jacc.2005.11.021

subject

Has Abstract

pub_date

2006-02-21 00:00:00

pages

752-6

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(05)02741-5

journal_volume

pub_type

杂志文章,多中心研究

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Health status identifies heart failure outpatients at risk for hospitalization or death.