Generic and disease-specific quality of life as a predictor of long-term mortality in heart failure.
OBJECTIVE
Although the vital prognosis of heart failure (HF) is generally poor, it varies substantially between patients. This study examined whether health-related quality of life (HRQoL) predicts long-term mortality in HF. It also evaluated the role of generic and disease-specific HRQoL questionnaires.


RESULTS
We studied 416 patients admitted for HF-related emergencies to four hospitals in Spain in 2000-2001. Health-related quality of life was measured at study baseline with a generic questionnaire, the SF-36, and with a disease-specific one, the Minnesota Living with Heart Failure (MLWHF) questionnaire. Patients were followed prospectively to 2007 to ascertain all-cause mortality. During follow-up, 290 (69.7%) patients died. After adjustment for biomedical, healthcare, and social variables, a poor mental component summary (MCS) score on the SF-36 was associated with higher mortality [hazard ratio (HR) 1.38; 95% confidence interval (CI) 1.06-1.76]. For MLWHF, a poor physical component summary (PCS) score predicted higher mortality (HR 1.31; 95% CI 1.01-1.70). In a stepwise Cox model that included the PCS scores of both the SF-36 and the MLWHF, only the PCS of the MLWHF was retained with P<0.05. However, when both MCS scores were included, only the MCS of the SF-36 was retained with P<0.05.


CONCLUSIONS
The SF-36 MCS and the MLWHF PCS predict long-term mortality in patients with HF. Future research should identify the determinants of HRQoL and refine interventions to improve it.
Zuluaga
Maria Clemencia
MC
Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Spain.
Guallar-Castillón
Pilar
P
López-García
Esther
E
Banegas
José R
JR
Conde-Herrera
Manuel
M
Olcoz-Chiva
Maite
M
Rodríguez-Pascual
Carlos
C
Rodriguez-Artalejo
Fernando
F
D000223:Adaptation, Psychological; D016001:Confidence Intervals; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000401:mortality* / Q000473:pathology / Q000523:psychology; D006801:Humans; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D018570:Risk Assessment; D013030:Spain / Q000453:epidemiology; D013315:Stress, Psychological; D011795:Surveys and Questionnaires