Assist Inferm Ric. 2009 Jan-Mar;28(1):21-6.
Aim of this paper is to explore and quanti-quantitatively assess whether QoL as measured with the Kansas City Cardiomiopathy Questionnaire (KCCQ) summary score could be considered as an independent relevant component of clinical prognostic score of morbidity and mortality and identify patients at risk for death or admissions.
Sixty-three per cent NYHA II and 39.4% NYHA III-IV patients experience a good Qol (score > 75). Risk factors for "not good" (< 75) QoL are age, NYHA class III-IV, diabetes, COPD and previous hospitalizations. NYHA II and III-IV patients with not good QoL experience an higher mortality than patients with a good QoL in the same classes. NYHA II patients with not good QoL experience the same 1 year readmission rates as NYHA III-IV patients with good QoL.
Quality of life scores identify patients with different risk of mortality and readmissions within the same NYHA class. The prognostic value of KCCQ summary scores could identify candidates for disease management in whom better targeted care strategies may reduce hospitalizations and prevent deaths.
本文旨在探索并定量评估用堪萨斯城心肌病问卷(KCCQ)总结评分衡量的生活质量(QoL)是否可被视为发病率和死亡率临床预后评分的一个独立相关组成部分,并识别有死亡或住院风险的患者。
63%的纽约心脏协会(NYHA)II级患者和39.4%的NYHA III-IV级患者生活质量良好(评分>75)。“生活质量不佳”(<75)的危险因素包括年龄、NYHA III-IV级、糖尿病、慢性阻塞性肺疾病(COPD)和既往住院史。NYHA II级和III-IV级中生活质量不佳的患者比同级别中生活质量良好的患者死亡率更高。NYHA II级中生活质量不佳的患者1年再入院率与NYHA III-IV级中生活质量良好的患者相同。
生活质量评分可识别同一NYHA级别内具有不同死亡和再入院风险的患者。KCCQ总结评分的预后价值可识别疾病管理的候选对象,针对这些对象采取更有针对性的护理策略可能会减少住院并预防死亡。