Anaemia, but not iron deficiency, is associated with clinical symptoms and quality of life in patients with severe heart failure and palliative home care: A substudy of the PREFER trial

Abstract

BackgroundTo explore the relationships between anaemia or iron deficiency (ID) and symptoms, quality of life (QoL), morbidity, and mortality. MethodsA post-hoc, non-prespecified, explorative substudy of the prospective randomized PREFER trial. One centre study of outpatients with severe HF and palliative need managed with advanced home care. Associations between anaemia, ID, and the Edmonton Symptom Assessment Scale (ESAS), Euro QoL (EQ-5D), Kansas City Cardiomyopathy Questions (KCCQ) were examined only at baseline but at 6months for morbidity and mortality. ResultsSeventy-two patients (51 males, 21 females), aged 79.2±9.1years. Thirty-nine patients (54%) had anaemia and 34 had ID (47%). Anaemia was correlated to depression (r=0.37; p=0.001), anxiety (r=0.25; p=0.04), and reduced well-being (r=0.26; p=0.03) in the ESAS; mobility (r=0.33; p=0.005), pain/discomfort (r=0.27; p=0.02), and visual analogue scale of health state (r=−0.28; p=0.02) in the EQ-5D; and physical limitation (r=−0.27; p=0.02), symptom stability; (r=−0.43; p<0.001); (r=−0.25; p=0.033), social limitation;(r=−0.26; p=0.03), overall summary score; (r=−0.24, p=0.046) and clinical summary score; (r=−0.27; p=0.02) in the KCCQ. ID did not correlate to any assessment item. Anaemia was univariably associated with any hospitalization (OR: 3.0; CI: 1.05–8.50, p=0.04), but not to mortality. ID was not significantly associated with any hospitalization or mortality. ConclusionAnaemia, but not ID, was associated although weakly with symptoms and QoL in patients with advanced HF and palliative home care.