title: Severity at entry to specialized heart failure clinics: discrepancies between health-related quality of life and function in men and women.
abstract: BACKGROUND
  We compared severity of heart failure (HF) between men and women at entry to the multidisciplinary HF clinic based on 3 measures: New York Heart Association functional class, norm-referenced 6-minute walk distance, and health-related quality of life.
  
  
  METHODS
  Newly admitted patients to 1 of 6 HF clinics were enrolled. Data were collected from a clinical database, questionnaires were administered to patients, and tests were administered by clinic nurses. We compared men and women with respect to the 3 severity indicators at entry to the clinic.
  
  
  RESULTS
  In adjusted analyses, women had a lower health-related quality of life (P = 0.04) but did not have lower norm-referenced 6-minute walk distance or lower New York Heart Association functional class on entry to the clinic. Having more comorbid conditions, being on medication, and having visited the emergency department or been admitted to hospital in the past 6 months were associated with higher severity at entry according to all 3 indicators.
  
  
  CONCLUSIONS
  Women report a lower health-related quality of life at entry to the clinic, although functional capacity does not seem to differ between women and men. Reasons for these discrepancies will need to be elucidated to better address women's health needs.
authors.affiliation: University of Montreal, Faculty of Medicine, School of Rehabilitation, and Public Health Department of Montreal, Montreal, Québec, Canada. debbie.feldman@umontreal.ca
authors.forename: Debbie Ehrmann
authors.initials: DE
authors.lastname: Feldman
authors.forename: Anique
authors.initials: A
authors.lastname: Ducharme
authors.forename: Nadia
authors.initials: N
authors.lastname: Giannetti
authors.forename: Marc
authors.initials: M
authors.lastname: Frenette
authors.forename: Caroline
authors.initials: C
authors.lastname: Michel
authors.forename: François
authors.initials: F
authors.lastname: Grondin
authors.forename: Richard
authors.initials: R
authors.lastname: Sheppard
authors.forename: Julie Des
authors.initials: JD
authors.lastname: Lauriers
authors.forename: Hassan
authors.initials: H
authors.lastname: Behlouli
authors.forename: Louise
authors.initials: L
authors.lastname: Pilote
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D005080:Exercise Test / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000145:classification* / Q000503:physiopathology / Q000628:therapy*; D006334:Heart Function Tests; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010101:Oxygen Consumption; D010343:Patient Admission / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration*; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D011792:Quebec; D012720:Severity of Illness Index; D012737:Sex Factors; D018434:Sickness Impact Profile; D013997:Time Factors; D016138:Walking / Q000502:physiology