Blum Moritz, McKendrick Karen, Gelfman Laura P, Goldstein Nathan E
Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Cardiovascular Surgery, Deutsches Herzzentrum der Charité Medical Heart Center of Charité and the German Heart Institute Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Qual Life Res. 2025 Feb;34(2):485-493. doi: 10.1007/s11136-024-03823-9. Epub 2024 Nov 6.
Quality of life (QOL) and functional status are two key outcomes for patients with advanced heart failure (HF). We examined the association of eleven symptoms with QOL and functional status impairment in patients with advanced HF.
This was a retrospective analysis of baseline data from a multi-center, cluster-randomized controlled trial (NCT01459744) which enrolled patients with an implanted cardioverter-defibrillator and advanced HF at high-risk for mortality. Study instruments included the Condensed Memorial Symptom Assessment Scale, the Kansas City Cardiomyopathy Questionnaire QOL subscale, and the number of activities of daily living (ADL) patients had difficulties with. The study included 413 subjects. In generalized linear models which were adjusted for baseline characteristics, the total number of symptoms was significantly associated with worse QOL, as was the presence of each individual symptom, except constipation. Lack of energy demonstrated the strongest negative association with QOL. Similarly, the total number of symptoms was associated with a higher number of ADL difficulties (i.e., worse functional status). The presence of pain, lack of energy and drowsiness was individually associated with more ADL difficulties.
Among patients with advanced HF, a higher number of symptoms and specific individual symptoms were associated with worse QOL and functional status.
生活质量（QOL）和功能状态是晚期心力衰竭（HF）患者的两个关键预后指标。我们研究了晚期HF患者中11种症状与QOL和功能状态损害之间的关联。
这是一项对多中心、整群随机对照试验（NCT01459744）基线数据的回顾性分析，该试验纳入了植入式心脏复律除颤器且晚期HF、死亡风险高的患者。研究工具包括简明纪念症状评估量表、堪萨斯城心肌病问卷QOL子量表，以及患者在日常生活活动（ADL）中存在困难的数量。该研究纳入了413名受试者。在针对基线特征进行调整的广义线性模型中，症状总数与较差的QOL显著相关，除便秘外，每种单独症状的存在也与较差的QOL显著相关。精力不足与QOL的负相关最强。同样，症状总数与更多的ADL困难（即更差的功能状态）相关。疼痛、精力不足和嗜睡的存在分别与更多的ADL困难相关。
在晚期HF患者中，更多的症状和特定的个体症状与更差的QOL和功能状态相关。
