title: Physical health status measures predict all-cause mortality in patients with heart failure.
abstract: BACKGROUND
  Physical health status measures have been shown to predict death in heart failure (HF); however, few studies found significant associations after adjustment for confounders, and most were not representative of all HF patients.
  
  
  RESULTS
  HF patients from southeastern MN were prospectively enrolled between 10/2007 and 12/2010, completed a 12-item Short Form Health Survey (SF-12) and a 6-minute walk, and were followed through 2011 for death from any cause. Scores ≤ 25 on the SF-12 physical component indicated low self-reported physical functioning, and the first question of the SF-12 measured self-rated general health. Low functional exercise capacity was defined as ≤ 300 m walked during a 6-minute walk. Over a mean follow-up of 2.3 years, 86 deaths occurred among the 352 participants. A 1.6-fold (95% confidence interval, 1.0-2.7) and 1.8-fold (95% confidence interval, 1.1-2.9) increased risk of death was observed among patients with low self-reported physical functioning and low functional exercise capacity, respectively. Poor self-rated general health corresponded to a 2.7-fold (95% confidence interval, 1.5-4.9) increased risk of death compared with good to excellent general health. All measures equally discriminated between who would die and who would survive (C-statistics: 0.729, 0.750, and 0.740 for self-reported physical functioning, self-rated general health, and functional exercise capacity, respectively).
  
  
  CONCLUSIONS
  Three physical health status measures, captured by the SF-12 and a 6-minute walk, equally predict death among community HF patients. Therefore, the first question of the SF-12, which is the least burdensome to administer, may be sufficient to identify HF patients at greatest risk of death.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Alanna M
authors.initials: AM
authors.lastname: Chamberlain
authors.forename: Sheila M
authors.initials: SM
authors.lastname: McNallan
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Dunlay
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Redfield
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kane
authors.forename: Susan A
authors.initials: SA
authors.lastname: Weston
authors.forename: Véronique L
authors.initials: VL
authors.lastname: Roger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015897:Comorbidity; D005080:Exercise Test; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006333:Heart Failure / Q000453:epidemiology / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011379:Prognosis; D011446:Prospective Studies
keywords: health status; heart failure; mortality; physical functioning; survival