Division of Cardiology and Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta.
J Pain Symptom Manage. 2011 Sep;42(3):379-87. doi: 10.1016/j.jpainsymman.2010.11.013. Epub 2011 Mar 27.
Heart failure (HF) is a leading cause of death and disability, and despite optimal care, patients may eventually require palliative care. Little is known about how palliative care questionnaires (the Edmonton Symptom Assessment Scale [ESAS] and the Palliative Performance Scale [PPS]) perform compared with HF assessment using the New York Heart Association (NYHA) functional class and the Kansas City Cardiomyopathy Questionnaire (KCCQ).
To assess the utility of a palliative care questionnaire in patients with HF.
One hundred and five patients (mean age=65 years, 76% male, mean ejection fraction=28%) followed in an HF clinic were surveyed with the NYHA, PPS, ESAS, and KCCQ.
The PPS and ESAS were each correlated to the NYHA class (P<0.0001 for both) and the KCCQ score (PPS: R(2)=0.57; ESAS: R(2)=-0.72; both P<0.0001). There were 33 patients who either died (10 deaths) or were hospitalized (26 patients) for more than one year. In addition to age and gender, a higher (worse) ESAS score trended toward significance (P=0.07) and a lower (worse) PPS was a significant (P=0.04) predictor of all-cause hospitalization or death.
In a cohort of HF patients, we found a modest correlation with NYHA class and KCCQ assessment with the PPS and ESAS, two standard palliative care questionnaires. Given the difficulty in identifying patients with HF eligible for palliative or hospice care, these tools may be of use in clinical practice.
心力衰竭（HF）是导致死亡和残疾的主要原因，尽管进行了最佳治疗，但患者最终可能仍需要姑息治疗。对于姑息治疗问卷（埃德蒙顿症状评估量表[ESAS]和姑息治疗表现量表[PPS]）与纽约心脏协会（NYHA）功能分级和堪萨斯城心肌病问卷（KCCQ）用于 HF 评估的比较，知之甚少。
评估姑息治疗问卷在 HF 患者中的应用价值。
对 105 例在 HF 门诊接受治疗的患者（平均年龄为 65 岁，76%为男性，平均射血分数为 28%）进行 NYHA、PPS、ESAS 和 KCCQ 调查。
PPS 和 ESAS 均与 NYHA 分级相关（均 P<0.0001），且与 KCCQ 评分相关（PPS：R²=0.57；ESAS：R²=-0.72；均 P<0.0001）。有 33 例患者死亡（10 例死亡）或因住院（26 例）超过一年。除年龄和性别外，较高（较差）的 ESAS 评分具有显著趋势（P=0.07），较低（较差）的 PPS 是全因住院或死亡的显著预测因素（P=0.04）。
在 HF 患者队列中，我们发现 PPS 和 ESAS 与 NYHA 分级和 KCCQ 评估具有适度相关性，这两种标准的姑息治疗问卷可能对临床实践有用。
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