Health-related quality of life in outpatients with chronic heart failure associated with sideropenic anemia

Abstract

The aim of this study was to assess the impact of anemia and iron deficiency on health-related quality of life (HRQoL) in outpatients with chronic congestive heart failure. The data were collected from patients with chronic congestive heart failure admitted to a university hospital outpatient clinic who agreed to be involved in the cross-sectional study. According to the World Health Organization’s cutoffs to define anemia, the patients were further divided into two groups, with and without anemia. HrQoL was assessed using two questionnaires: a disease-specific instrument, the chronic heart failure questionnaire (CHFQ), and a generic instrument, the Sickness Impact Profile (SIP). The standardized questionnaire was used to collect data regarding patients’ gender, age, marital status, place of living, education, occupation, and duration of diseases and comorbidities. To assess the iron status, ferritin, serum iron, the total iron binding capacity/TIBC and transferrin were measured. In total, 200 outpatients with congestive heart failure were included in the study, 100 with and 100 without anemia. Patients with anemia were mainly female, had longer duration of disease (p = 0.001) and more hospitalizations (p = 0.001). Independent associations were found between the HrQoL and hemoglobin level (p = 0.049), HrQoL and hematocrit value (p = 0.006) and HrQoL and NYHA functional class (p = 0.004). Iron deficiency was not associated with impaired HrQoL. Anemia has a significant impact on self-perceived health. Anemic patients are more likely to have worse heart failure as indicated by a higher NYHA class, thus being at higher risk for a decline of HrQoL compared with non-anemic patients.