European Journal of Heart Failure Advance Access originally published online on March 28, 2009
European Journal of Heart Failure 2009 11(5):518-524; doi:10.1093/eurjhf/hfp038
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Self-rated health and mortality in patients with chronic heart failure
1 Chair of Public Health, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
2 Department of Cardiology, University of Hull, Kingston upon Hull, UK
3 Division of Cardiology, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik 36, SI-4204 Golnik, Slovenia
4 Department of Internal Medicine, General Hospital Murska Sobota, Murska Sobota, Slovenia
5 Division of Applied Cachexia Research, Department of Cardiology, Campus Virchow Clinic, Charité-Universitätsmedizin Berlin, Germany
* Corresponding author. Tel: +386 31 379 533, Fax: +386 4 25 69 117, Email: mitja.lainscak{at}guest.arnes.si
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Abstract |
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Aims: In patients with chronic heart failure (CHF), there is limited information on self-rated health (SRH). We aimed to examine the distribution of SRH and whether SRH is associated with mortality in patients with stable CHF.
Methods and results: We enrolled 100 patients (71 ± 11 years, 54% men, left ventricular ejection fraction 47 ± 11%) in a prospective study with 48 months of follow-up. Self-rated health was assessed using a seven-grade descriptive scale: very good, good, quite good, average, quite poor, poor, and very poor. Median SRH was quite poor and the most frequent SRH (31 patients) was average. During an average follow-up of 1005 ± 507 days, 58 patients died. More patients in the group that rated their health as quite poor or worse died (70% vs. 43%, P = 0.008). In a Cox proportional hazard model, SRH as a seven-grade descriptive scale [hazard ratios (HR) 1.39, 95% CI 1.10–1.74] or as a median value (HR 2.13, 95% CI 1.23–3.69) predicted mortality. The association remained significant after adjustment for patient characteristics and biomarkers (P < 0.05 for both).
Conclusion: In patients with stable CHF, SRH independently predicts mortality. This suggests that SRH could be used in everyday clinical practice to obtain important prognostic information beyond clinical examination and laboratory work-up.
Key Words: Chronic heart failure • Mortality • Self-rated health
Received October 6, 2008; Revised January 23, 2009; Accepted February 6, 2009