Patients' self-assessed functional status in heart failure by New York Heart Association class: a prognostic predictor of hospitalizations, quality of life and death.
Patients' self-assessed functional status in heart failure by New York Heart Association class: a prognostic predictor of hospitalizations, quality of life and death.
复制标题
DOI：
10.1016/j.cardfail.2009.08.010
复制
发表时间：
2010-02
影响因子：
6
通讯作者：
Brooksby, Iain
中科院分区：
文献类型：
--
作者：
Holland, Richard;Rechel, Boika;Stepien, Karolina;Harvey, Ian;Brooksby, Iain
临床医师指定的纽约心脏协会（NYHA）分级是心力衰竭结局的既定预测因素。本研究旨在测试患者通过NYHA分级对功能状态的自我评估是否可预测住院率、生活质量和死亡率。这是一项随机对照试验中的观察性研究。在英国诺福克的3家急性医院急诊入院后，共招募了293例诊断为心力衰竭的成人患者。结果指标包括6个月内急诊入院的数量，6个月时用明尼苏达心力衰竭生活问卷（MLHFQ）和EQ-5D自我评估的生活质量，以及随访20个月内的死亡。根据患者自我分配的NYHA分级（SA-NYHA），将患者分为3个NYHA组（I/II、III和IV）。Poisson模型表明再入院率增加与较高的SA-NYHA分级相关（校正率比1.21; 95% CI 1.04-1.41; P = .02）。基线时SA-NYHA分级越高，6个月随访时的生活质量越差（MLHFQ P = .002; EQ-5D P = .047），并与死亡率较高相关（校正风险比1.84; 95% CI 1.10-3.06; P = .02）。SA-NYHA分级可预测心力衰竭患者的住院率、生活质量和死亡率。
Clinician-assigned New York Heart Association (NYHA) class is an established predictor of outcomes in heart failure. This study aims to test whether patients' self-assessment of functional status by NYHA class predicts hospital admissions, quality of life, and mortality. This was an observational study within a randomized controlled trial. A total of 293 adult patients diagnosed with heart failure were recruited after an emergency admission at 3 acute hospitals in Norfolk, UK. Outcome measures included number of emergency admissions over 6 months, self-assessed quality of life measured with the Minnesota Living with Heart Failure questionnaire (MLHFQ) and EQ-5D at 6 months, and deaths up to 20 months' follow-up. Patients were grouped into 3 NYHA groups (I/II, III, and IV) based on patients' self-assigned NYHA class (SA-NYHA). A Poisson model indicated an increased readmission rate associated with higher SA-NYHA class (adjusted rate ratio 1.21; 95% CI 1.04–1.41; P = .02). Higher SA-NYHA class at baseline predicted worse quality of life at 6 months' follow-up (P = .002 for MLHFQ; P = .047 for EQ-5D), and was associated with higher mortality rate (adjusted hazard ratio 1.84; 95% CI 1.10–3.06; P = .02). SA-NYHA class is predictive of hospitalization, quality of life, and mortality among patients with heart failure.
登录
查看更多内容
影响因子：
4.8
作者：
Ahmed, A;Aronow, WS;Fleg, JL
通讯作者：
Fleg, JL
影响因子：
2.8
作者：
Subramanian, U;Weiner, M;Murray, MD
通讯作者：
Murray, MD
影响因子：
39.3
作者：
MADSEN, BK;HANSEN, JF;MORTENSEN, LS
通讯作者：
MORTENSEN, LS
影响因子：
6
作者：
Rector, T S;Tschumperlin, L K;Silver, M A
通讯作者：
Silver, M A
影响因子：
--
作者：
Holland, Richard;Brooksby, Lain;Harvey, Ian
通讯作者：
Harvey, Ian