title: Self-rated health and mortality in patients with chronic heart failure.
abstract: OBJECTIVE
  In patients with chronic heart failure (CHF), there is limited information on self-rated health (SRH). We aimed to examine the distribution of SRH and whether SRH is associated with mortality in patients with stable CHF.
  
  
  RESULTS
  We enrolled 100 patients (71 +/- 11 years, 54% men, left ventricular ejection fraction 47 +/- 11%) in a prospective study with 48 months of follow-up. Self-rated health was assessed using a seven-grade descriptive scale: very good, good, quite good, average, quite poor, poor, and very poor. Median SRH was quite poor and the most frequent SRH (31 patients) was average. During an average follow-up of 1005 +/- 507 days, 58 patients died. More patients in the group that rated their health as quite poor or worse died (70% vs. 43%, P = 0.008). In a Cox proportional hazard model, SRH as a seven-grade descriptive scale [hazard ratios (HR) 1.39, 95% CI 1.10-1.74] or as a median value (HR 2.13, 95% CI 1.23-3.69) predicted mortality. The association remained significant after adjustment for patient characteristics and biomarkers (P < 0.05 for both).
  
  
  CONCLUSIONS
  In patients with stable CHF, SRH independently predicts mortality. This suggests that SRH could be used in everyday clinical practice to obtain important prognostic information beyond clinical examination and laboratory work-up.
authors.affiliation: Chair of Public Health, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Jerneja
authors.initials: J
authors.lastname: Farkas
authors.forename: Samantha
authors.initials: S
authors.lastname: Nabb
authors.forename: Lijana
authors.initials: L
authors.lastname: Zaletel-Kragelj
authors.forename: John G F
authors.initials: JG
authors.lastname: Cleland
authors.forename: Mitja
authors.initials: M
authors.lastname: Lainscak