Avtor/Urednik		Inkrot, Simone; Lainščak, Mitja; Edelmann, Frank; Lončar, Goran; Stanković, Ivan; Ćelić, Vera; Apostolović, Svetlana; Tahirović, Elvis; Trippel, Tobias D.; Herrmann-Lingen, Christoph; Gelbrich, Götz; Düngen, Hans-Dirk
Naslov		Poor self-rated health predicts mortality in patients with stable chronic heart failure
Tip		članek
Vol. in št.		Letnik 15, št. 7
Leto izdaje		2016
Obseg		str. 504-512
ISSN		1474-5151 - European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology
Jezik		eng
Abstrakt		Aims: In heart failure, a holistic approach incorporating the patient's perspective is vital for prognosis and treatment. Self-rated health has strong associations with adverse events and short-term mortality risk, but long-term data are limited. We investigated the predictive value of two consecutive self-rated health assessments with regard to long-term mortality in a large, well characterised sample of elderly patients with stable chronic heart failure. Methods and results: We measured self-rated health by asking In general, would you say your health is: 1, excellent; 2, very good; 3, good; 4, fair; 5, poor? twice: at baseline and the end of a 12-week beta-blocker up-titration period in the CIBIS-ELD trial. Mortality was assessed in an observational follow-up after 2-4 years. A total of 720 patients (mean left ventricular ejection fraction 45+/-12%, mean age 73+/-5 years, 36% women) rated their health at both time points. During long-term follow-up, 144 patients died (all-cause mortality 20%). Fair/poor self-rated health in at least one of the two reports was associated with increased mortality (hazard ratio 1.42 per level; 95% confidence interval 1.16-1.75; P<0.001). It remained independently significant in multiple Cox regression analysis, adjusted for N-terminal pro B-type natriuretic peptide (NTproBNP), heart rate and other risk prediction covariates. Self-rated health by one level worse was as predictive for mortality as a 1.9-fold increase in NTproBNP. Conclusion: Poor self-rated health predicts mortality in our long-term follow-up of patients with stable chronic heart failure, even after adjustment for established risk predictors. We encourage clinicians to capture patient-reported selfrated health routinely as an easy to assess, clinically meaningful measure and pay extra attention when self-rated health is poor.
Deskriptorji		Heart failure Mortality Aged Srčno popuščanje Smrtnost Starostniki