Global perceived health and ten-year cardiovascular mortality in elderly primary care patients with possible heart failure.
BACKGROUND
Although multi-item health-related quality of life (HRQoL) instruments provide prognostic information, they are rarely used in routine clinical practice.


OBJECTIVE
To examine whether a single question about global perceived health (GPH) was a prognostic indicator of cardiovascular (CV) mortality over 10 years of follow-up in elderly patients with possible heart failure (HF) in primary care.


METHODS
GPH was measured using the first question on the Short-Form-36 concerning current health status. Of the 510 patients who underwent baseline evaluation, 448 patients were included.


RESULTS
Cox proportional regression hazard analysis controlled for age, sex, NYHA class, diabetes, ischaemic heart disease, left ventricular ejection fraction and B-type natriuretic peptide plasma concentrations, showed that patients with GPH rated as "poor" or "good" were at four (HR 4.1 CI 95% 1.8-9.4) and three times (HR 3.4 CI 95% 1.4-7.8) the risk of CV mortality, respectively.


CONCLUSIONS
GPH is an independent predictor of CV mortality in elderly patients with possible HF. As a complement to clinical factors when evaluating severity of HF, GPH could be an important tool for identifying patients at risk of adverse CV events and in need of improved treatment.
Johansson
Peter
P
Department of Cardiology, Linköping University Hospital, Linköping, Sweden. peter.johansson@aries.vokby.se
Broström
Anders
A
Dahlström
Ulf
U
Alehagen
Urban
U
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000523:psychology; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006333:Heart Failure / Q000401:mortality* / Q000523:psychology; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011581:Psychological Tests; D011594:Psychometrics; D011788:Quality of Life; D012938:Social Perception; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors