Changing health related quality of life and outcomes in heart failure by age, sex and subtypeResearch in context
Summary: Background: There are calls to integrate serial recordings of health related quality of life (HRQoL) into routine care, clinical trials and prognosis. Little is known about the relationship between change in HRQoL and outcomes in heart failure (HF) patients by age, sex and HF subtype. Meth...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537023003942 |
| _version_ | 1797683009831305216 |
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| author | Claire A. Lawson Lina Benson Iain Squire Francesco Zaccardi Mohammad Ali Simon Hand Umesh Kadam Wan Ting Tay Ulf Dahlstrom Lars H. Lund Gianluigi Savarese Carolyn S.P. Lam Kamlesh Khunti Anna Strömberg |
| author_facet | Claire A. Lawson Lina Benson Iain Squire Francesco Zaccardi Mohammad Ali Simon Hand Umesh Kadam Wan Ting Tay Ulf Dahlstrom Lars H. Lund Gianluigi Savarese Carolyn S.P. Lam Kamlesh Khunti Anna Strömberg |
| author_sort | Claire A. Lawson |
| collection | DOAJ |
| description | Summary: Background: There are calls to integrate serial recordings of health related quality of life (HRQoL) into routine care, clinical trials and prognosis. Little is known about the relationship between change in HRQoL and outcomes in heart failure (HF) patients by age, sex and HF subtype. Method: From the Swedish Heart Failure Registry (SwedeHF; 2008–2019), patients were categorised by reduced (<40%, HFrEF), mildly-reduced (40–49%, HFmrEF) and preserved (≥50%, HFpEF) ejection fraction. HRQoL was measured using Euro-QoL-5D visual analogue scale (EQ5D-vas), collected at baseline and 1-year. Baseline EQ5D-vas scores were categorised by: “best” (76–100), “good” (51–75), “bad” (26–50), and “worst” (0–25). Change in EQ5D-vas was categorised as ‘no significant change’ (<5 points increase/decrease); some worsening (5–9 points decrease); considerable worsening (≥10 points decrease); some improvement (5–9 points increase); considerable improvement (≥10 points increase). Associations with admission and death were estimated and interactions with patient sub-groups tested. Findings: Among 23,553 patients (median age 74 [66–81] years, 8000 [34%] female), baseline EQ5D-vas was worse in older patients, women, and those with HFpEF compared to their respective counterparts. Compared to patients with the “best” EQ5D-vas, the adjusted associations for admission for those with “good”, “bad” and “worst” EQ5D-vas were, respectively: HR 1.09 (1.04, 1.14), 1.27 (1.21, 1.33) and 1.39 (1.28, 1.51). Compared to no significant change in EQ5D-vas, the adjusted estimates for admission following some improvement, considerable improvement, some worsening and considerable worsening were, respectively: HR 0.91 (0.82, 1.01), 0.75 (0.70, 0.81), 1.04 (0.92, 1.16) and 1.25 (1.16, 1.35). Results were similar amongst groups and for HF admission and death. Interpretation: Change in HRQoL was an independent indicator of risk of admission and death in people with all HF subtypes, irrespective of age and sex. Funding: NIHR. |
| first_indexed | 2024-03-12T00:09:13Z |
| format | Article |
| id | doaj.art-7b674d06225e40e7afd53e7ad52bc7cd |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-03-12T00:09:13Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-7b674d06225e40e7afd53e7ad52bc7cd2023-09-16T05:31:27ZengElsevierEClinicalMedicine2589-53702023-10-0164102217Changing health related quality of life and outcomes in heart failure by age, sex and subtypeResearch in contextClaire A. Lawson0Lina Benson1Iain Squire2Francesco Zaccardi3Mohammad Ali4Simon Hand5Umesh Kadam6Wan Ting Tay7Ulf Dahlstrom8Lars H. Lund9Gianluigi Savarese10Carolyn S.P. Lam11Kamlesh Khunti12Anna Strömberg13Department of Cardiovascular Sciences, University of Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre –Cardiology, Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester, Leicestershire, United Kingdom; Corresponding author. Department of Cardiovascular Sciences & Real World Evidence Unit, University of Leicester Leicester, Leicestershire LE5 4PW, England, United Kingdom.Karolinska Institutet, Stockholm, SwedenDepartment of Cardiovascular Sciences, University of Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre –Cardiology, Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester, Leicestershire, United Kingdom; Karolinska Institutet, Stockholm, SwedenLeicester Real World Evidence Unit, University of Leicester, Leicestershire, United Kingdom; Diabetes Centre, University of Leicester, Leicestershire, United Kingdom; National Institute for Health Research (NIHR) Applied Research Collaboration - East Midlands (ARC-EM), University of Leicester, Leicestershire, United KingdomDepartment of Cardiovascular Sciences, University of Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre –Cardiology, Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester, Leicestershire, United KingdomHealth Sciences, University of Leicester, Leicestershire, United KingdomHealth Sciences, University of Leicester, Leicestershire, United KingdomHeart Centre Singapore, SingaporeDepartment of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, SwedenKarolinska Institutet, Stockholm, Sweden; Duke-National University of Singapore, SingaporeKarolinska Institutet, Stockholm, SwedenHeart Centre Singapore, SingaporeLeicester Real World Evidence Unit, University of Leicester, Leicestershire, United Kingdom; Diabetes Centre, University of Leicester, Leicestershire, United Kingdom; National Institute for Health Research (NIHR) Applied Research Collaboration - East Midlands (ARC-EM), University of Leicester, Leicestershire, United KingdomDepartment of Health, Medicine and Caring Sciences, and Department of Cardiology, Linkoping University, SwedenSummary: Background: There are calls to integrate serial recordings of health related quality of life (HRQoL) into routine care, clinical trials and prognosis. Little is known about the relationship between change in HRQoL and outcomes in heart failure (HF) patients by age, sex and HF subtype. Method: From the Swedish Heart Failure Registry (SwedeHF; 2008–2019), patients were categorised by reduced (<40%, HFrEF), mildly-reduced (40–49%, HFmrEF) and preserved (≥50%, HFpEF) ejection fraction. HRQoL was measured using Euro-QoL-5D visual analogue scale (EQ5D-vas), collected at baseline and 1-year. Baseline EQ5D-vas scores were categorised by: “best” (76–100), “good” (51–75), “bad” (26–50), and “worst” (0–25). Change in EQ5D-vas was categorised as ‘no significant change’ (<5 points increase/decrease); some worsening (5–9 points decrease); considerable worsening (≥10 points decrease); some improvement (5–9 points increase); considerable improvement (≥10 points increase). Associations with admission and death were estimated and interactions with patient sub-groups tested. Findings: Among 23,553 patients (median age 74 [66–81] years, 8000 [34%] female), baseline EQ5D-vas was worse in older patients, women, and those with HFpEF compared to their respective counterparts. Compared to patients with the “best” EQ5D-vas, the adjusted associations for admission for those with “good”, “bad” and “worst” EQ5D-vas were, respectively: HR 1.09 (1.04, 1.14), 1.27 (1.21, 1.33) and 1.39 (1.28, 1.51). Compared to no significant change in EQ5D-vas, the adjusted estimates for admission following some improvement, considerable improvement, some worsening and considerable worsening were, respectively: HR 0.91 (0.82, 1.01), 0.75 (0.70, 0.81), 1.04 (0.92, 1.16) and 1.25 (1.16, 1.35). Results were similar amongst groups and for HF admission and death. Interpretation: Change in HRQoL was an independent indicator of risk of admission and death in people with all HF subtypes, irrespective of age and sex. Funding: NIHR.http://www.sciencedirect.com/science/article/pii/S2589537023003942Heart failureHealthHospitalizationMortalityPrognosis |
| spellingShingle | Claire A. Lawson Lina Benson Iain Squire Francesco Zaccardi Mohammad Ali Simon Hand Umesh Kadam Wan Ting Tay Ulf Dahlstrom Lars H. Lund Gianluigi Savarese Carolyn S.P. Lam Kamlesh Khunti Anna Strömberg Changing health related quality of life and outcomes in heart failure by age, sex and subtypeResearch in context EClinicalMedicine Heart failure Health Hospitalization Mortality Prognosis |
| title | Changing health related quality of life and outcomes in heart failure by age, sex and subtypeResearch in context |
| title_full | Changing health related quality of life and outcomes in heart failure by age, sex and subtypeResearch in context |
| title_fullStr | Changing health related quality of life and outcomes in heart failure by age, sex and subtypeResearch in context |
| title_full_unstemmed | Changing health related quality of life and outcomes in heart failure by age, sex and subtypeResearch in context |
| title_short | Changing health related quality of life and outcomes in heart failure by age, sex and subtypeResearch in context |
| title_sort | changing health related quality of life and outcomes in heart failure by age sex and subtyperesearch in context |
| topic | Heart failure Health Hospitalization Mortality Prognosis |
| url | http://www.sciencedirect.com/science/article/pii/S2589537023003942 |
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