title: Insufficient self-care is an independent risk factor for adverse clinical outcomes in Japanese patients with heart failure.
abstract: Self-care is a cornerstone for the successful management of heart failure (HF). The purpose of this study was to examine the impacts of HF self-care on prognosis in Japanese patients with HF. A total of 283 HF outpatients (age 64 ± 14, 70% male, 52% HFrEF) were enrolled. We asked patients to answer about their adhevence to 5 self-care behaviors (medication, eating a low-sodium diet, regular exercise, daily weight check, and treatment seeking behavior). On the basis of the results, we classified patients into a good self-care group and a poor self-care group. The primary outcome was HF hospitalization and/or cardiac death. In total, 65% of patients were classified into the poor self-care group. During a median follow-up of 2 years, cardiac events occurred more frequently in the poor self-care group (22% versus 9.6%, P = 0.013). Poor self-care was an independent risk factor for cardiac events in Cox regression analysis adjusted for clinical parameters (hazard ratio = 2.86, P = 0.005). Poor self-care was also associated with an increased number of HF hospitalizations as well as an extended length of hospital stay for HF. Poor knowledge about HF was an independent determinant for poor self-care in multivariate logistic regression analysis (odds ratio = 0.92, P = 0.019). Insufficient self-care is an independent risk factor for cardiac events in Japanese patients with HF.
authors.affiliation: Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Graduate School of Medicine.
authors.forename: Naoko
authors.initials: N
authors.lastname: Kato
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kinugawa
authors.forename: Etsuko
authors.initials: E
authors.lastname: Nakayama
authors.forename: Takako
authors.initials: T
authors.lastname: Tsuji
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Kumagai
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Imamura
authors.forename: Hisataka
authors.initials: H
authors.lastname: Maki
authors.forename: Taro
authors.initials: T
authors.lastname: Shiga
authors.forename: Masaru
authors.initials: M
authors.lastname: Hatano
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yao
authors.forename: Chikako
authors.initials: C
authors.lastname: Miura
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
mesh_terms: D000368:Aged; D044466:Asian People; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012648:Self Care / Q000592:standards*