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西班牙慢性收缩性心力衰竭患者的健康相关生活质量:VIDA-IC研究结果

Health-related Quality of Life of Patients With Chronic Systolic Heart Failure in Spain: Results of the VIDA-IC Study.

作者信息

Comín-Colet Josep, Anguita Manuel, Formiga Francesc, Almenar Luis, Crespo-Leiro María G, Manzano Luis, Muñiz Javier, Chaves José, de Frutos Trinidad, Enjuanes Cristina

机构信息

Programa de Insuficiencia Cardiaca, Servicio de Cardiología, Hospital del Mar, Barcelona, Spain; Grupo de Investigación Biomédica en Enfermedades del Corazón, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain.

Programa de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.

出版信息

Rev Esp Cardiol (Engl Ed). 2016 Mar;69(3):256-71. doi: 10.1016/j.rec.2015.07.030. Epub 2015 Dec 23.

Abstract

INTRODUCTION AND OBJECTIVES

Although heart failure negatively affects the health-related quality of life of Spanish patients there is little information on the clinical factors associated with this issue.

METHODS

Cross-sectional multicenter study of health-related quality of life. A specific questionnaire (Kansas City Cardiomyopathy Questionnaire) and a generic questionnaire (EuroQoL-5D) were administered to 1037 consecutive outpatients with systolic heart failure.

RESULTS

Most patients with poor quality of life had a worse prognosis and increased severity of heart failure. Mobility was more limited and rates of pain/discomfort and anxiety/depression were higher in the study patients than in the general population and patients with other chronic conditions. The scores on both questionnaires were very highly correlated (Pearson r =0.815; P < .001). Multivariable linear regression showed that being older (standardized β=-0.2; P=.03), female (standardized β=-10.3; P < .001), having worse functional class (standardized β=-20.4; P < .001), a higher Charlson comorbidity index (standardized β=-1.2; P=.005), and recent hospitalization for heart failure (standardized β=6.28; P=.006) were independent predictors of worse health-related quality of life.

CONCLUSIONS

Patients with heart failure have worse quality of life than the general Spanish population and patients with other chronic diseases. Female sex, being older, comorbidity, advanced symptoms, and recent hospitalization are determinant factors in health-related quality of life in these patients.

摘要

引言与目的

尽管心力衰竭会对西班牙患者与健康相关的生活质量产生负面影响,但关于与此问题相关的临床因素的信息却很少。

方法

对与健康相关的生活质量进行横断面多中心研究。向1037名连续的收缩性心力衰竭门诊患者发放了一份特定问卷(堪萨斯城心肌病问卷)和一份通用问卷(欧洲五维健康量表)。

结果

大多数生活质量较差的患者预后更差,心力衰竭的严重程度更高。与普通人群和其他慢性病患者相比,本研究患者的活动能力更受限,疼痛/不适及焦虑/抑郁发生率更高。两份问卷的得分高度相关(Pearson相关系数r = 0.815;P < 0.001)。多变量线性回归显示,年龄较大(标准化β = -0.2;P = 0.03)、女性(标准化β = -10.3;P < 0.001)、功能分级较差(标准化β = -20.4;P < 0.001)、Charlson合并症指数较高(标准化β = -1.2;P = 0.005)以及近期因心力衰竭住院(标准化β = 6.28;P = 0.006)是与健康相关生活质量较差的独立预测因素。

结论

心力衰竭患者的生活质量比西班牙普通人群和其他慢性病患者更差。女性、年龄较大、合并症、症状严重及近期住院是这些患者与健康相关生活质量的决定性因素。

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