title: Generic and disease-specific quality of life as a predictor of long-term mortality in heart failure.
abstract: 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.
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Spain.
authors.forename: Maria Clemencia
authors.initials: MC
authors.lastname: Zuluaga
authors.forename: Pilar
authors.initials: P
authors.lastname: Guallar-Castillón
authors.forename: Esther
authors.initials: E
authors.lastname: López-García
authors.forename: José R
authors.initials: JR
authors.lastname: Banegas
authors.forename: Manuel
authors.initials: M
authors.lastname: Conde-Herrera
authors.forename: Maite
authors.initials: M
authors.lastname: Olcoz-Chiva
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodríguez-Pascual
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodriguez-Artalejo
mesh_terms: 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