title: Self-rating of quality of life provides additional prognostic information in heart failure. Insights into the EPICAL study.
abstract: BACKGROUND
  The relationship between quality of life (QoL) and survival have been poorly investigated. The aim of this study was to determine the value of QoL score as a prognostic factor in a prospective cohort of patients with advanced chronic heart failure (CHF).
  
  
  METHODS
  QoL assessment was performed with a generic questionnaire: the Duke Health Profile (DHP) and a disease-specific instrument: the Minnesota Living With Heart Failure Questionnaire (LIhFE), in a sample of 108 patients registered in the EPICAL program (hospitalised patients with severe CHF defined by a NYHA grade III/IV, oedema or hypotension, and LVEF < 30%). Prognostic value of general, physical, mental and social dimensions on survival and hospital-free survival were tested in a Cox model.
  
  
  RESULTS
  One-year survival rate was 76%, 1-year hospital-free survival 38%. QoL was significantly associated with outcomes: for both questionnaires, a 10-point decrement in baseline score was associated with a 23-36% increase in the risk of death or hospitalisation for heart failure. For hospital-free survival, this relationship remained significant after adjustment for others prognostic factors.
  
  
  CONCLUSIONS
  QoL score is a predictive factor of survival and an independent predictive factor of hospital-free survival in patients with advanced CHF. This assessment may provide additional information for clinical management and therapeutic decisions.
authors.affiliation: Department of Epidemiology, University Hospital, Nancy, France. f.alla@chu-nancy.fr
authors.forename: François
authors.initials: F
authors.lastname: Alla
authors.forename: Serge
authors.initials: S
authors.lastname: Briançon
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
authors.forename: Yves
authors.initials: Y
authors.lastname: Juillière
authors.forename: Paul-Michel
authors.initials: PM
authors.lastname: Mertès
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Villemot
authors.forename: Faiez
authors.initials: F
authors.lastname: Zannad
mesh_terms: D000704:Analysis of Variance; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate