Abstract 17808: Perceived Health Predicts Risk of Hospitalizations and Death in Adults with Heart Failure

Abstract

Background: Hospitalization and death are common in adults with heart failure (HF). The purpose of this study is to determine whether overall perceived health can predict all-cause hospitalization or death in HF patients. Methods: A secondary analysis was conducted using data collected on 280 Stage C HF patients from three U.S. northeastern sites. Perceived health was measured at enrollment with the question, “In general would you say your health is, excellent, very good, good, fair, or poor?” Data on hospitalization and death were obtained from the medical record or US death records. We compared the rate of events among patients with poor or fair perceptions of health to those with good or excellent perceptions of health. A Cox proportional hazards model was used to examine the association between perceived health and event rates. Kaplan-Meier survival estimates were compared between groups. Results: The sample was older (mean=62 SD 12.5 years), 64.3% male, 76.4% NYHA class III/IV, 69% with systolic HF (ejection fraction 35.4% SD 17%), and 39% ischemic etiology. Few patients (13.2%) rated their health as being poor. During a 180-day follow-up period, 6 deaths and 91 hospitalizations occurred as first events. Among patients with events, 64.9% perceived their health as poor and 33.9% perceived their health as fair. Controlling for 8 confounders (site, age, race, gender, NYHA class, HF type, HF knowledge, Charlson Comorbidity Index), patients with poor perceived health had over double the rate of dying or being hospitalized (hazard ratio (HR): 2.5; 95% confidence interval (CI): 1.3 to 4.7; p=0.007). CONCLUSION: Perceived health is a powerful indicator of impending events. Asking HF patients how they perceive their health can be a simple and quick tool for prioritizing patients who are at highest risk of death and hospitalization.