Department Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Am Schwarzenberg 15, D-97078, Würzburg, Germany.
Department Medicine I, University Hospital Würzburg, Würzburg, Germany.
Sci Rep. 2024 Jul 14;14(1):16236. doi: 10.1038/s41598-024-64939-z.
Knowledge about a patient's physical fitness can aid in medical decision-making, but objective assessment can be challenging and time-consuming. We aimed to investigate the concordance of self-reported health status and physical functioning with the 6 minute walking distance (6MWD) as objective measure of physical performance. The prospective characteristics and course of heart failure stages A/B and determinants of progression (STAAB) cohort study iteratively follows a representative sample of residents of the city of Würzburg, Germany, aged 30-79 years, without a history of heart failure (HF). The 6MWD was measured in 2752 individuals (aged 58 ± 11 years, 51% women) from a population-based cohort under strictly standardized conditions. Self-reported health status and physical functioning were assessed from items of the short form 36 (SF-36). After the respective classification of self-reported health status and physical functioning into 'good', 'moderate', and 'poor', we determined the association of these categories with 6MWD by applying a generalized linear model adjusted for age and sex. Prevalence of self-reported good/moderate/poor general health and physical functioning was 41/52/7% and 45/48/7%, respectively. Mean 6MWD in the respective categories was 574 ± 70/534 ± 76/510 ± 87 m, and 574 ± 72/534 ± 73/490 ± 82 m, with significant sex-specific differences between all categories (all p < 0.001) as well as significant differences between the respective groups except for the categories 'moderate' and 'poor' health status in men. This cross-sectional analysis revealed a strong association between self-reported health status and physical functioning with the objective assessment of 6MWD, suggesting that physicians can rely on their patients' respective answers. Nevertheless, sex-specific perception and attribution of general health and physical functioning deserve further in-depth investigation. Decision-making based on self-reported health requires prospective evaluation in population-based cohorts as well as adult inpatients.
关于患者身体状况的知识可以辅助医疗决策，但客观评估可能具有挑战性且耗时。我们旨在研究自我报告的健康状况和身体机能与 6 分钟步行距离（6MWD）之间的一致性，6MWD 是身体机能的客观测量指标。前瞻性心力衰竭 A/B 期特征和进展决定因素（STAAB）队列研究不断跟踪德国维尔茨堡市代表性的 30-79 岁居民样本，这些人没有心力衰竭（HF）病史。在严格标准化条件下，从基于人群的队列中测量了 2752 名个体（年龄 58±11 岁，51%为女性）的 6MWD。自我报告的健康状况和身体机能通过简短形式 36 项（SF-36）的项目进行评估。在将自我报告的健康状况和身体机能分别分类为“良好”、“中等”和“差”之后，我们通过应用调整年龄和性别的广义线性模型来确定这些类别与 6MWD 的关联。自我报告的良好/中等/差一般健康和身体机能的患病率分别为 41/52/7%和 45/48/7%。相应类别的平均 6MWD 分别为 574±70/534±76/510±87m 和 574±72/534±73/490±82m，所有类别之间均存在显著的性别特异性差异（所有 p<0.001），以及除了男性健康状况的“中等”和“差”类别之外，各个组之间的差异也具有统计学意义。这项横断面分析显示，自我报告的健康状况和身体机能与 6MWD 的客观评估之间存在很强的关联，这表明医生可以依赖患者的各自回答。然而，一般健康和身体机能的性别特异性感知和归因值得进一步深入研究。基于自我报告的健康状况做出的决策需要在基于人群的队列以及成年住院患者中进行前瞻性评估。
