Predictors and outcomes of quality of life in elderly patients with heart failure

Abstract

Study objectiveThis study aims to identify predictors of health related quality of life (HRQoL) among patients with heart failure (HF) and assess whether HRQoL was a predictor of rehospitalisation and mortality, and if age influenced the findings. DesignObservational cohort study. SettingSeven hospitals in the Northern Sydney Local Health District, Sydney, Australia. ParticipantsCommunity dwelling patients who completed a Minnesota Living with HF questionnaire (MLHFQ) within 30 days of discharge after a HF hospitalisation. Main outcome measureMultivariable linear regression models were used to identify predictors of MLHFQ scores (higher score = worse HRQoL) and adjusted Cox regression models to assess the impact of MLHFQ scores on one-year rehospitalisation and mortality. Separate analyses were conducted for those aged ≤80 or >80 years. Results1911 patients of mean age 79 years (57 % aged >80 years) were included in this analysis. Among those aged ≤80 years; younger age, lower haemoglobin and presenting symptoms at hospitalisation of exertional dyspnoea, peripheral oedema and fatigue were predictors of worse post-discharge MLHFQ scores. In patients aged >80 years, living alone, chronic kidney disease, exertional dyspnoea and peripheral oedema were predictors of worse MLHFQ scores. Worse MLHFQ scores predicted one-year HF readmissions in those aged >80 years (HR 1.22, 95 % CI 1.07–1.37) but not those aged ≤80 years (HR 0.90 95 % CI 0.71–1.10). ConclusionsIn-hospital predictors can be identified for worse HRQoL post-discharge for HF. These vary according to age, and should be addressed prior to discharge.