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

18 Scopus citations

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 (US)
Pages (from-to)803-811
Number of pages9
JournalJournal of Clinical Epidemiology
Volume60
Issue number8
DOIs
StatePublished - Aug 1 2007

Keywords

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

ASJC Scopus subject areas

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

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