Kuan Wai Chee, Lim Ka Keat, Chee Kok Han, Kasim Sazzli, Dujaili Juman Abdulelah, Lee Kenneth Kwing-Chin, Teoh Siew Li
School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia.
Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London, SE1 1UL, United Kingdom.
Qual Life Res. 2025 Feb;34(2):471-484. doi: 10.1007/s11136-024-03818-6. Epub 2024 Oct 30.
This study aimed to examine the trajectory in health-related quality of life (HRQoL) during and after hospitalisation for worsening of heart failure (HF) in Malaysia.
200 patients with heart failure and reduced ejection fraction (HFrEF) admitted into two hospitals in Malaysia due to worsening of HF were surveyed using the EQ-5D-5 L questionnaire. The primary outcomes were utility values at admission, discharge and 1-month post-discharge (1MPD). Secondary outcomes included the visual analogue scores (VAS) and the proportion of patients reporting each EQ-5D-5 L dimension levels. Missing data were imputed using multiple imputation, and generalised linear mixed models were fitted.
At admission, the unadjusted mean utility values and VAS scores for HFrEF patients in Malaysia were as low as 0.150 ± 0.393 and 38.2 ± 20.8, respectively. After a median hospital stay of 4 days, there was a significant improvement in utility values and VAS scores by 0.510 (95% CI: 0.455-0.564) and 28.8 (95% CI: 25.5-32.1), respectively. The utility value and VAS score at 1-month post-discharge were not significantly different from discharge. The proportion of HFrEF patients reporting problems and severe problems in mobility, self-care, usual activities, and anxiety/depression, pain/discomfort reduced at varying degree from admission to discharge and 1MPD.
HF is a progressive condition with substantial variation in HRQoL during the disease trajectory. During hospitalisation due to worsening of HF, HFrEF population has unfavourable HRQoL. Rapid and significant HRQoL improvement was observed at discharge, which sustained over one month. The study findings can inform future cost-effectiveness analyses and policies.
本研究旨在调查马来西亚因心力衰竭（HF）恶化而住院期间及出院后与健康相关的生活质量（HRQoL）轨迹。
采用EQ-5D-5L问卷对马来西亚两家医院因HF恶化入院的200例射血分数降低的心力衰竭（HFrEF）患者进行调查。主要结局为入院时、出院时及出院后1个月（1MPD）的效用值。次要结局包括视觉模拟评分（VAS）以及报告每个EQ-5D-5L维度水平的患者比例。使用多重插补法填补缺失数据，并拟合广义线性混合模型。
入院时，马来西亚HFrEF患者未经调整的平均效用值和VAS评分分别低至0.150±0.393和38.2±20.8。中位住院4天后，效用值和VAS评分分别显著提高了0.510（95%CI：0.455-0.564）和28.8（95%CI：25.5-32.1）。出院后1个月的效用值和VAS评分与出院时无显著差异。从入院到出院及1MPD，报告在行动、自我护理、日常活动以及焦虑/抑郁、疼痛/不适方面存在问题和严重问题的HFrEF患者比例有不同程度的降低。
HF是一种进行性疾病，在疾病轨迹中HRQoL存在很大差异。因HF恶化住院期间，HFrEF人群的HRQoL较差。出院时观察到HRQoL迅速且显著改善，并持续了一个月。研究结果可为未来的成本效益分析和政策提供参考。
