Predictors of mortality in patients with chronic heart failure at the outpatient stage

Objective. To assess the factors influencing mortality over a one-year follow-up period in outpatients with chronic heart failure and with preserved and mildly reduced left ventricular ejection fraction. Materials and methods. An open prospective controlled non-randomized study included 292 patients who were followed in the City Polyclinic No. 8, Tyumen, Russia, during 2021–2024. A total of 89 parameters were assessed, characterizing heart failure (severity of structural heart abnormalities, left ventricular ejection fraction, six-minute walk test, NT-proBNP levels and their dynamics); comorbid conditions; pharmacotherapy; vaccination status during the study period; and psycho-emotional characteristics (scores on the Hospital Anxiety and Depression Scale [HADS], Morisky-Green test, Type D personality assessment [DS-14], self-care ability according to the EHFScBS-9 questionnaire, and self-assessed cognitive impairment using the McNair and Kahn scale). Results. In the group of deceased patients, a higher body mass index (p = 0.034), higher Charlson comorbidity index score (p = 0.001), and higher self-care score (p = 0.015) were observed, along with a slightly lower baseline six-minute walk test result in meters (p = 0.065). A binary logistic regression prognostic model was developed based on the analysis of mortality causes during the follow-up period. For continuous variables identified as significant factors, ROC analysis was performed. Conclusion . A subgroup of patients with chronic heart failure and with preserved and mildly reduced ejection fraction was identified as having an increased risk of mortality during the one-year outpatient follow-up period. This group included patients with NYHA functional class III–IV heart failure, obesity, a Charlson comorbidity index score greater than 4, reduced self-care ability, and Type D personality