title: A single health status question had important prognostic value among outpatients with chronic heart failure.
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.
  
  
  METHODS
  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 (chi2=26.1, hazard ratio [HR]=1.63, confidence interval [CI]: 1.35, 1.97; P<0.0001) and Charlson index (chi2=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 (chi2=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.
authors.affiliation: Roudebush VAMC, Indiana University School of Medicine, Indianapolis, IN, USA. usubrama@ipui.edu
authors.forename: Usha
authors.initials: U
authors.lastname: Subramanian
authors.forename: George
authors.initials: G
authors.lastname: Eckert
authors.forename: Ada
authors.initials: A
authors.lastname: Yeung
authors.forename: William M
authors.initials: WM
authors.lastname: Tierney
mesh_terms: D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D008297:Male; D010045:Outpatients; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D018401:Sample Size; D011795:Surveys and Questionnaires; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D014728:Veterans