Physical and psychological symptom profiling and event-free survival in adults with moderate to advanced heart failure

Christopher Lee, Jill Gelow, Quin Denfeld, James Mudd, Donna Burgess, Jennifer K. Green, Shirin O. Hiatt, Corrine Y. Jurgens

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

: Heart failure (HF) is a heterogeneous symptomatic disorder. The goal of this study was to identify and link common profiles of physical and psychological symptoms to 1-year event-free survival in adults with moderate to advanced HF. Methods: Multiple valid, reliable, and domain-specific measures were used to assess physical and psychological symptoms. Latent class mixture modeling was used to identify distinct symptom profiles. Associations between observed symptom profiles and 1-year event-free survival were quantified using Cox proportional hazards modeling. Results: The mean age of the participants (n = 202) was 57 ± 13 years, 50% were men, and 60% had class III/IV HF. Three distinct profiles, mild (41.7%), moderate (30.2%), and severe (28.1%), that captured a gradient of both physical and psychological symptom burden were identified (P <.001 for all comparisons). Controlling for the Seattle HF Score, adults with the moderate symptom profile were 82% more likely (hazard ratio, 1.82; 95% confidence interval, 1.07-3.11; P = .028) and adults with the severe symptom profile were more than twice as likely (hazard ratio, 2.06; 95% confidence interval, 1.21-3.52; P = .001) to have a clinical event within 1 year than patients with the mild symptom profile. Conclusions: Profiling patterns among physical and psychological symptoms identifies HF patient subgroups with significantly worse 1-year event-free survival independent of prognostication based on objective clinical HF data.

Original languageEnglish (US)
Pages (from-to)315-323
Number of pages9
JournalJournal of Cardiovascular Nursing
Volume29
Issue number4
DOIs
Publication statusPublished - 2014

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Keywords

  • Heart failure
  • survival
  • symptoms

ASJC Scopus subject areas

  • Advanced and Specialized Nursing
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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