title: Quality of life assessment for acute heart failure patients from emergency department presentation through 30 days after discharge: a pilot study with the Kansas City Cardiomyopathy Questionnaire.
abstract: BACKGROUND
  There are no well validated patient-reported disease status instruments for acute heart failure (HF). We assessed the feasibility of using the Kansas City Cardiomyopathy Questionnaire (KCCQ) during acute heart failure hospitalization, and the association of acute changes with 30-day readmission.
  
  
  RESULTS
  A convenience sample of acute HF patients were administered the KCCQ on presentation, discharge, and 30 days after discharge. We examined mean differences in KCCQ scores over time, and we stratified by readmission status to examine differences in hospital-based changes with the use of t test and logistic regression. Among 52 patients (mean age 63 ± 35 years, 56.9% male, 46.2% white), discharge and 30-day assessments were each completed by 90%. Scores were lowest at presentation, improved during hospitalization, and were highest at 30 days. The mean change was +11.9 ± 97.0 (P = .007) between presentation and discharge and +19.8 ± 87.8 (P < .001) between discharge and 30 days. Within the 30-day follow-up, 10 patients were readmitted, and there were no significant differences in score changes during hospitalization between patients with and without readmission (readmitted patients: +4.8 ± 81.5 vs no readmission +16.2 ± 27.4; P = .32).
  
  
  CONCLUSIONS
  In this pilot study, the KCCQ is feasible to use during acute HF hospitalizations and demonstrates sensitivity to acute changes, but score changes during hospitalization did not predict 30-day readmission.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program and Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan; Department of Veterans Affairs, VA Center for Clinical Management and Research, Ann Arbor VA Healthcare System, Ann Arbor, Michigan. Electronic address: ksauser@med.umich.edu.
authors.forename: Kori
authors.initials: K
authors.lastname: Sauser
authors.affiliation: Section of Cardiology, Department of Medicine, University of Missouri, Kansas City, Missouri; Mid America Heart Institute, Saint Hospital, Kansas City, Missouri.
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Linda
authors.initials: L
authors.lastname: Pierchala
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Evan
authors.initials: E
authors.lastname: Davis
authors.affiliation: Department of Emergency Medicine, Chicago, Illinois; Center for Cardiovascular Innovation, Department of Medicin, Chicago, Illinois; Institute for Public Health and Medicine, Chicago, Illinois.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Pang
mesh_terms: D000208:Acute Disease; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000523:psychology / Q000628:therapy; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Patient-reported health status; acute heart failure; emergency department; readmission