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生活质量是心力衰竭患者死亡率的独立预测因素:一项来自哥伦比亚心力衰竭登记处(RECOLFACA)的前瞻性队列研究。

Quality of life is an independent predictor of mortality in patients with heart failure: a prospective cohort study from the Colombian heart failure registry (RECOLFACA).

作者信息

Gómez-Mesa Juan Esteban, Luna-Bonilla Paula, Echeverría Luis Eduardo, Rivera-Toquica Alex, Jurado-Arenales Adriana Milena, Orozco María Johanna, Buitrago-Malaver Lilia Andrea, Rivera Edilma L, González Diana Verónica, Coronado-Villa Estefanny, Toro-Cardona Olga Cristina, López-Montes Cristian Alexander, Vargas-Márquez Ludy Yanet, Martínez-Camargo Silvia, Agudelo-Pérez Adriana, Vivas-Mayor Marcela, Niño Lina María, Mejía-Cadavid Luz Aida, Aponte-Romero Luisa Fernanda, Erazo María José, García-Barrera María, Meza-Roque Julio Armando, Ríos-Sánchez Viviana, Torres-Moreno Fabián, Castañeda-M Jenny, Gallego Cesar A, Martínez Fanny Esther, Blandón-Córdoba Carmen Jineth, Silva-Carmona Mónica, Saldarriaga Clara

机构信息

Department of Cardiology, Fundación Valle del Lili, Street 98 #18-49, 760026 Cali, Colombia.

Department of Health Sciences, Universidad Icesi, Cali, Colombia.

出版信息

Eur J Cardiovasc Nurs. 2025 Jan 30;24(1):71-80. doi: 10.1093/eurjcn/zvae117.

Abstract

AIMS

Patients with heart failure (HF) commonly have poor quality of life (QoL), secondary to the persistence and severity of HF symptoms. We aimed to evaluate the prognostic value of QoL measures on all-cause mortality in patients with HF from the Colombian registry of heart failure (RECOLFACA).

METHODS AND RESULTS

We analysed data from patients registered in RECOLFACA during 2017-19. QoL was measured using the EuroQol-5D questionnaire (EQ-5D). From the questionnaire, two independent predictors of mortality were obtained, the visual analogue scale (VAS) and the utility score (US). The primary outcome was all-cause mortality, and secondary variables evaluated were demographic factors, comorbidities, NYHA classification, medications used, and laboratory test results. To analyse survival among patients, the Kaplan-Meier method and the hierarchical Cox proportional hazards regression model were used. This study included 2514 patients from RECOLFACA. Most patients were male (57.6%), and the mean age was 67.8 years. The mean value and standard deviation (SD) of the VAS score was 78.8 ± 20.1 points, while the mean and SD of the US score was 0.81 ± 0.20. As the Kaplan-Meier curve illustrated, patients in the lower quartiles of both VAS and US scores had a significantly higher probability of mortality (log-rank test: P < 0.001 for both scores).

CONCLUSION

QoL, as calculated by the EQ-5D questionnaire, served as an independent predictor of mortality in patients from RECOLFACA. Further studies may be needed to evaluate whether the provision of optimizing therapies and follow-up care based on patients' perceived QoL reduces short- and long-term mortality rates in this population.

摘要

目的

心力衰竭(HF)患者的生活质量(QoL)通常较差,这是由HF症状的持续存在和严重程度所致。我们旨在评估哥伦比亚心力衰竭登记处(RECOLFACA)中QoL测量指标对HF患者全因死亡率的预后价值。

方法与结果

我们分析了2017 - 19年在RECOLFACA登记的患者数据。使用欧洲五维度健康量表(EQ - 5D)问卷测量QoL。从该问卷中获得了两个独立的死亡率预测指标,即视觉模拟量表(VAS)和效用评分(US)。主要结局是全因死亡率,评估的次要变量包括人口统计学因素、合并症、纽约心脏协会(NYHA)分级、使用的药物以及实验室检查结果。为分析患者的生存率,采用了Kaplan - Meier方法和分层Cox比例风险回归模型。本研究纳入了来自RECOLFACA的2514例患者。大多数患者为男性(57.6%),平均年龄为67.8岁。VAS评分的平均值和标准差(SD)为78.8±20.1分,而US评分的平均值和SD为0.81±0.20。正如Kaplan - Meier曲线所示,VAS和US评分处于较低四分位数的患者死亡率显著更高(对数秩检验:两个评分的P均<0.001)。

结论

EQ - 5D问卷计算得出的QoL是RECOLFACA患者死亡率的独立预测指标。可能需要进一步研究来评估基于患者感知的QoL提供优化治疗和随访护理是否能降低该人群的短期和长期死亡率。

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