Social status, health-related quality of life, and event-free survival in patients with heart failure

BACKGROUND: Social status may impact health-related quality of life (HRQOL), hospitalization, and mortality in patients with heart failure (HF). PURPOSE: To determine if social status was associated with HRQOL and event-free survival. HYPOTHESES: Higher social status (quality of perceived support, emotional support, marital status, and economic status) is related to better HRQOL and event-free survival after controlling covariates (New York Heart Association [NYHA] functional class, comorbidity status, and age). METHODS: Patients (N = 147, 61 ± 11 years old, 70% male, 62% NYHA class III/IV) provided data on HRQOL (measured by the Minnesota Living with Heart Failure questionnaire) and social status. Event-free survival data were collected by medical record reviews and patient or family interviews. Hierarchical regression analysis and survival analysis were used to test the hypothesis. RESULTS: Better quality of perceived support, better economic status, better functional status, older age, and less comorbidity were related to better HRQOL (R2 = .365, p = <.001). Only economic status predicted event-free survival. CONCLUSION: Attention should be given to those who have lower social support to improve HRQOL and those who have lower economic status to improve event-free survival.