Oregon Health & Science University School of Nursing, SN-ORD, 3455 S.W. U.S. Veterans Hospital Road Portland, OR 97239-2941, USA.
University of California Davis Betty Irene Moore School of Nursing, Sacramento, CA, USA.
Heart Lung. 2020 Mar-Apr;49(2):151-157. doi: 10.1016/j.hrtlng.2019.11.004. Epub 2019 Nov 18.
The relationship between physical and affective symptom clusters in heart failure (HF) is unclear.
To identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups.
This was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively.
In this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3%), incongruent (13.9%), and congruent-severe (16.8%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival.
Congruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.
心力衰竭（HF）患者的躯体和情感症状群之间的关系尚不清楚。
确定 HF 患者躯体和情感症状群之间的关联，并量化症状亚组的结局和决定因素。
这是两项针对成人 HF 患者的队列研究数据的二次分析。使用交叉分类模型比较躯体和情感症状群。使用 Cox 比例风险模型和多项逻辑回归分别识别症状亚组的结局和决定因素。
在这个年轻、以男性为主的样本（n=274）中，躯体和情感症状群在一个拟合度可接受的模型中交叉分类。确定了三个症状亚组：一致轻度（69.3%）、不一致（13.9%）和一致重度（16.8%）。与一致轻度症状组相比，不一致症状组的 180 天无事件生存率显著降低。
在识别预后不良风险较高的患者时，应考虑躯体和情感症状群之间的一致性。
