Multidisciplinary management of elderly patients with chronic heart failure: five year outcome measures in death and survivor groups.
BACKGROUND
The utility of multidisciplinary chronic disease evaluation measures, especially health related quality of life (HRQL), for long long-term prognostic use in elderly patients with heart failure is uncertain.


OBJECTIVE
To report on clinical, functional and HRQL values of deceased and surviving patients of a 6-month RCT of Cardiac Rehabilitation in addition to specialist nurse outpatient clinic at 5 years.


METHODS
The original measures (walk test, Borg RPE, MLHF, EuroQol score and vas, biochemistry) were repeated for patients in a satisfactory condition.


RESULTS
Five year survival was characterised by significantly better baseline values for LV dysfunction and NYHA class and 6-month values for MLHF, physical function and biochemistry measures. EuroQuol scores were worse than baseline for surviving patients at 5 years, in contrast to MLHF scores. The walk test gave the highest 5-year relative mortality risk, whereas the MLHF gave similar values to the Borg and uric acid measures. Deaths were more evident in normal weight older patients than in younger obese patients.


CONCLUSIONS
Changes in patient measures were evident over 5 years and most differentiated between survivor and deceased groups. In comparison to the use of the MLHF and EuroQuol-vas, the EuroQuol score was limited by impairments of the ageing process.
Austin
Jacky
J
Gwent Healthcare Trust, Nevill Hall Hospital, Abergavenny, Monmouthshire, United Kingdom. jackie.austin@gwent.wales.nhs.uk
Williams
W Robert
WR
Hutchison
Stephen
S
D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D002908:Chronic Disease; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000401:mortality / Q000451:nursing / Q000534:rehabilitation; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000401:mortality; D010348:Patient Care Team / Q000706:statistics & numerical data*; D011788:Quality of Life; D019145:Rehabilitation Nursing / Q000706:statistics & numerical data*; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000451:nursing / Q000534:rehabilitation