Prognostic Impact of Self-Reported Health on Clinical Outcomes in Patients with Heart Failure

Anne Ankerstjerne Rasmussen, Signe Holm Larsen, Martin Jensen, Selina Kikkenborg Berg, Trine Bernholdt Rasmussen, Britt Borregaard, Lars Thrysoee, Charlotte Brun Thorup, Rikke Elmose Mols, Henrik Wiggers, Søren Paaske Johnsen

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AIMS: An in-depth understanding of the prognostic value of patient-reported outcomes (PRO) is essential to facilitate person-centred care in heart failure (HF). This study aimed to clarify the prognostic role of subjective mental and physical health status in patients with HF.

METHODS AND RESULTS: Patients with HF were identified from the DenHeart Survey (n = 1,499) and PRO data were obtained at hospital discharge, including the EuroQol five-dimensional questionnaire (EQ-5D), the HeartQoL and the Hospital Anxiety and Depression Scale (HADS). Clinical baseline data were obtained from medical records and linked to nationwide registries with patient-level data on sociodemographics and healthcare contacts. Outcomes were all-cause and cardiovascular (CV) mortality, CV events and HF hospitalisation with one- and three-year follow-up.Analysing the PRO data on a continuous scale, a worse score in the following were associated with risk of all-cause and CV mortality after one year: the HeartQoL (adjusted HRs 1.91, 95% CI:1.42-2.57 and 2.17, 95% CI:1.50-3.15, respectively), the EQ-5D (adjusted HRs 1.26, 95% CI: 1.15-1.38 and 1.27, 95% CI: 1.13-1.42, respectively), the HADS depression subscale (adjusted HRs 1.12, 95% CI: 1.07-1.17 and 1.11, 95% CI: 1.05-1.17, respectively), and the HADS anxiety subscale (adjusted HRs 1.08, 95% CI: 1.03-1.13 and 1.09, 95% CI: 1.04-1.15, respectively). Three-year results were overall in concordance with the one-year results. A similar pattern was also observed for non-fatal outcomes.

CONCLUSION: Health-related quality of life and symptoms of anxiety and depression at discharge were associated with all-cause and CV mortality at one- and three-year follow-up.

TidsskriftEuropean Heart Journal - Quality of Care and Clinical Outcomes
StatusE-pub ahead of print - 31. mar. 2020

Bibliografisk note

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions please email:

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