Key result
Each additional physical symptom in advanced HF is linked to a ~4-point lower quality of life-QOL score.
Why the study?
Quality of life and functional status are key outcomes in advanced HF, motivating an examination of how eleven symptoms associate with both measures.
Cross-Sectional (n=413)
Yes
In patients with advanced heart failure, a higher burden of physical symptoms—particularly lack of energy, pain, and drowsiness—is significantly associated with worse quality of life and greater functional impairment.
Answers are grounded in this paper and cite their sources.
Symptom burden may guide supportive care in advanced HF; hypothesis-generating and requires longitudinal confirmation before practice change.
BACKGROUND: 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. METHODS AND RESULTS: 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. CONCLUSION: Among patients with advanced HF, a higher number of symptoms and specific individual symptoms were associated with worse QOL and functional status.
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Blum et al. (2024) conducted a cross-sectional in Advanced heart failure (n=413). Symptom burden (total number of symptoms) vs. Lower symptom burden was evaluated on Kansas City Cardiomyopathy Questionnaire - Quality of Life Subscale (KCCQ-QOL) score (MD -4.1, 95% CI -5.1, -3.1, p=< 0.001). In patients with advanced heart failure, each additional physical symptom was associated with a 4.1-point reduction in the quality of life-QOL score and increased difficulties with activities of daily living.
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