Independent predictors of quality of life in patients with chronic heart failure.

Abstract

Introduction: Objective measurement of Health-Related Quality of Life (HRQoL) has proven useful in evaluating the effectiveness of medical management and its potential as a predictor of mortality and rehospitalization in patients with heart failure (HF). The aim of this study is to characterize HRQoL and determine its independent predictors in patients with chronic HF from a heart failure and transplant clinic in Colombia.

Methods: This was an analytical cross-sectional study. The outcome variable was HRQoL measured using The Minnesota Living with Heart Failure Questionnaire (MLHFQ). Descriptive analysis of sociodemographic and clinical characteristics was conducted. Simple and multiple linear regressions were performed to establish predictors, considering statistical significance at p < 0.05.

Results: A total of 200 patients were analyzed. 20% had Chagasic etiology. The median left ventricular ejection fraction (LVEF) was 30% (range 10 - 68%). The mean HRQoL score was 38.71 points (SD ± 22.67 points). "Multivariate analysis identified seven independent predictors of worse HRQoL: age (β=0.17), low vs. high socioeconomic status (β=13.45), HF etiology, Chagas vs. others (β=12.97), number of hospitalizations in the last year (β=2.94), Charlson index (β=3.47), digitalis use (β=7.34), and NYHA functional class III-IV vs. I-II (β=28.04). Angiotensin-converting enzyme use was associated with better HRQoL (β=-4.80).

Conclusion: This study shows that HRQoL in chronic HF is significantly determined by a set of socioeconomic, clinical, and management factors. The identification of these predictors underpins the need for comprehensive and personalized care strategies to improve the quality of life of these patients.