A single health status question had important prognostic value among outpatients with chronic heart failure

Usha Subramanian, George Eckert, Ada Yeung, William M. Tierney

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: Health status is an important marker of the impact of disease on function among patients with chronic heart failure (CHF). However, the prognostic value of CHF-specific health status on long-term mortality has not been adequately evaluated. Our objective was to assess CHF-specific health status and 5-year mortality among outpatients with CHF. Study Design and Setting: We analyzed data from 494 Veterans Affairs outpatients with diagnoses of CHF and objective evidence of left ventricular dysfunction who enrolled in a quality improvement intervention. We extracted information about comorbid diagnoses, severity of illness (Charlson index), health care utilization, drug therapy, laboratory, and vital sign data along with generic and CHF-specific health status. We then identified multivariate correlates of subsequent mortality at 5 years. Results: Five-year mortality was 44%. Age (χ2 = 26.1, hazard ratio [HR] = 1.63, confidence interval [CI]: 1.35, 1.97; P < 0.0001) and Charlson index (χ2 = 12.9, HR = 1.39, CI: 1.16, 1.67; P = 0.0003) were significantly associated with 5-year mortality. Controlling for clinical, lab, medication, and administrative data, a single-item assessing change in CHF-specific health status was independently associated with 5-year mortality (χ2 = 11.4, HR = 0.87, CI: 0.80, 0.94, P = 0.0007). Conclusions: Given the strength of the association with mortality, health care providers should routinely assess this single-item change in health status among outpatients with CHF to identify higher risk patients and guide therapy.

Original languageEnglish
Pages (from-to)803-811
Number of pages9
JournalJournal of Clinical Epidemiology
Volume60
Issue number8
DOIs
StatePublished - Aug 2007

Fingerprint

Health Status
Outpatients
Heart Failure
Mortality
Confidence Intervals
Severity of Illness Index
Patient Acceptance of Health Care
Vital Signs
Left Ventricular Dysfunction
Veterans
Quality Improvement
Health Personnel
Drug Therapy

Keywords

  • Chronic heart failure
  • Comorbidities
  • Health status
  • Mortality
  • Outcomes
  • Outpatients
  • Predictors

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

A single health status question had important prognostic value among outpatients with chronic heart failure. / Subramanian, Usha; Eckert, George; Yeung, Ada; Tierney, William M.

In: Journal of Clinical Epidemiology, Vol. 60, No. 8, 08.2007, p. 803-811.

Research output: Contribution to journalArticle

Subramanian, Usha ; Eckert, George ; Yeung, Ada ; Tierney, William M. / A single health status question had important prognostic value among outpatients with chronic heart failure. In: Journal of Clinical Epidemiology. 2007 ; Vol. 60, No. 8. pp. 803-811.
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