Health-related quality of life in elderly patients hospitalized with chronic heart failure

Figures & data

Table 1 Baseline patient characteristics (n=136)

Characteristic	Value
Age (years)	77.8±5.9
Male sex	72 (52.9)
Marital status
Married	47 (34.6)
Single, divorced, widowed	89 (65.4)
Education
>12 years	27 (19.9)
≤12 years	109 (80.1)
Number of household members	2.4±1.4
Household income (monthly, US dollars)	447.2±297.7
Duration of CHF (months)	61.9±71.1
Previous
Myocardial infarction	44 (32.4)
Angina	80 (58.8)
Hypertension	101 (74.3)
Diabetes mellitus	42 (30.9)
Three or more comorbidities	90 (66.2)
Current medications
Diuretics	128 (94.1)
Aldosterone antagonists	67 (49.3)
ACEIs	104 (76.5)
ARBs	3 (2.2)
Beta-blockers	69 (50.7)
Digoxin	41 (30.1)
Anticoagulants	51 (37.5)
Number of drugs	6.9±2.3
NYHA class
I	2 (1.5)
II	36 (26.5)
III	63 (46.3)
IV	35 (25.7)
LVEF (%)	40.9±11.0
Depressive symptoms	76 (55.9)
Cognitive impairment	71 (52.2)
Length of hospital stay (days)	18.0±9.5
MLHFQ score
Total	50.4±19.3
Physical	25.3±9.4
Emotional	10.6±6.5

Notes: Data are presented as the mean ± standard deviation or number (%).

Abbreviations: CHF, chronic heart failure; ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin II receptor blockers; NYHA, New York Heart Association; LVEF, left ventricular ejection fraction; MLHFQ, Minnesota Living with Heart Failure questionnaire.

Table 2 Demographic factors associated with health-related quality of lifea

	Total MLHFQ score	P-value	Physical MLHFQ score	P-value	Emotional MLHFQ score	P-value
Age	−0.070	0.420	−0.043	0.620	0.024	0.777
Gender
Male	48.6±19.7	0.227	24.0±9.8	0.075	10.1±6.0	0.264
Female	52.3±18.7		26.9±8.8		11.3±7.0
Marital status
Married	50.9±20.4	0.810	25.1±9.6	0.810	10.4±6.4	0.824
Unmarried	50.1±18.8		25.5±9.4		10.8±6.6
Education	−0.135	0.118	−0.179	0.038	−0.142	0.102
Number of household members	0.121	0.161	0.081	0.347	0.181	0.035
Household income	−0.252	0.013	−0.254	0.012	−0.057	0.576

Notes:

a Univariate analysis. HRQOL was assessed using the MLHFQ; higher scores represent more impaired HRQOL. Data are presented as the mean ± standard deviation, Pearson’s product-moment correlation coefficient, or Spearman’s rank correlation coefficient.

Abbreviations: MLHFQ, Minnesota Living with Heart Failure questionnaire; HRQOL, health-related quality of life.

Table 3 Clinical factors associated with health-related quality of lifea

	Total MLHFQ score	P-value	Physical MLHFQ score	P-value	Emotional MLHFQ score	P-value
Duration of CHF	0.224	0.010	0.223	0.011	0.151	0.085
Previous MI
Yes	52.0±19.0	0.373	25.5±10.3	0.684	11.2±6.2	0.418
No	49.6±19.4		25.3±9.0		10.4±6.6
Previous AP
Yes	51.6±19.0	0.325	25.8±9.9	0.344	10.8±6.6	0.796
No	48.6±19.6		24.7±8.7		10.5±6.4
Hypertension
Yes	49.1±19.9	0.130	24.8±9.4	0.255	10.1±6.5	0.084
No	54.0±17.1		26.9±9.5		12.2±6.4
Diabetes mellitus
Yes	49.8±17.9	0.904	24.0±8.9	0.180	11.3±6.7	0.365
No	50.6±19.9		25.9±9.6		10.3±6.4
Number of comorbidities	−0.053	0.538	−0.045	0.604	−0.039	0.649
NYHA class
I or II	39.3±18.2	<0.001	19.3±9.8	<0.001	8.5±5.5	0.023
III or IV	54.7±18.0		27.7±8.2		11.5±6.6
LVEF (%)
≥40	49.3±18.7	0.661	25.1±9.1	0.699	10.7±6.4	0.568
<40	51.5±19.9		25.5±9.9		10.4±6.6
Depressive symptoms
Yes	57.9±17.6	<0.001	28.5±8.9	<0.001	13.1±6.4	<0.001
No	40.9±17.1		21.4±8.6		7.5±5.0
Cognitive impairment
Yes	53.8±20.7	0.030	26.6±9.8	0.062	12.1±7.2	0.022
No	46.7±17.0		24.0±8.9		9.1±5.2
Length of hospital stay	0.198	0.021	0.162	0.060	0.199	0.020

Notes:

a Univariate analysis. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire; higher scores represent more impaired HRQOL. Data are presented as the mean ± standard deviation, Pearson’s product-moment correlation coefficient, or Spearman’s rank correlation coefficient.

Abbreviations: MLHFQ, Minnesota Living with Heart Failure questionnaire; CHF, chronic heart failure; MI, myocardial infarction; AP, angina pectoris; NYHA, New York Heart Association; LVEF, left ventricular ejection fraction; HRQOL, health-related quality of life.

Table 4 Current medications associated with health-related quality of lifea

	Total MLHFQ score	P-value	Physical MLHFQ score	P-value	Emotional MLHFQ score	P-value
Diuretics
Yes	51.1±19.4	0.060	25.6±9.4	0.109	10.8±6.6	0.496
No	38.4±13.9		20.6±8.9		8.9±4.1
Aldosterone antagonists
Yes	53.7±20.2	0.046	26.9±9.3	0.048	11.4±7.0	0.231
No	47.2±17.9		23.8±9.3		9.9±6.0
ACEIs
Yes	50.8±20.2	0.731	25.0±9.5	0.443	11.1±6.7	0.230
No	49.0±16.2		26.4±9.3		9.2±5.6
Beta-blockers
Yes	49.6±21.4	0.555	24.4±10.0	0.272	10.9±7.0	0.709
No	51.2±17.0		26.3±8.7		10.4±5.9
Digoxin
Yes	54.5±17.8	0.049	27.2±9.0	0.128	12.1±6.8	0.115
No	48.6±19.7		24.6±9.5		10.0±6.3
Anticoagulants
Yes	49.6±19.0	0.681	24.3±8.8	0.219	10.5±6.6	0.751
No	50.8±19.5		26.0±9.8		10.7±6.4
Number of drugs	0.170	0.047	0.146	0.090	0.119	0.168

Notes:

a Univariate analysis. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire; higher scores represent more impaired HRQOL. Data are presented as the mean ± standard deviation or Spearman’s rank correlation coefficient.

Abbreviations: MLHFQ, Minnesota Living with Heart Failure questionnaire; ACEIs, angiotensin-converting enzyme inhibitors; HRQOL, health-related quality of life.

Table 5 Independent predictors of health-related quality of lifea

	Sβ	P-value
Depressive symptoms	0.407	<0.001
NYHA class	0.229	0.021
Duration of CHF	0.179	0.049
Digoxin	0.139	0.125
Income	−0.206	0.029
Length of hospital stay	0.105	0.240
Diuretics	−0.039	0.682
Cognitive impairment	0.005	0.959
Aldosterone antagonists	−0.023	0.811
Number of drugs	0.027	0.784

Notes:

a Multiple linear regression analysis. R²=0.402; R² (adjusted) =0.330. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire.

Abbreviations: HRQOL, health-related quality of life; NYHA, New York Heart Association; Sβ, standard partial regression coefficient; CHF, chronic heart failure; R², coefficient of determination.