Self-reported health status and the associated risk of mortality in heart failure: The DANISH trial

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  • Johan S. Bundgaard, University of Copenhagen
  • ,
  • Jens J. Thune, University of Copenhagen
  • ,
  • Christian Torp-Pedersen, Nordsjællands Hospital - Hillerød, Aalborg University
  • ,
  • Jens C. Nielsen
  • Jens Haarbo, University of Copenhagen
  • ,
  • Rasmus Rørth, University of Copenhagen
  • ,
  • Lars Videbæk, Odense University Hospital
  • ,
  • Thomas Melchior, University of Copenhagen
  • ,
  • Susanne S. Pedersen, University of Southern Denmark, Odense University Hospital
  • ,
  • Lars Køber, University of Copenhagen
  • ,
  • Ulrik M. Mogensen, University of Copenhagen

Objective: To examine the gradual association between self-reported health status and mortality in patients with heart failure (HF) as current research has focused on poor health status and increased risk of mortality. Method: This is a substudy of the DANISH (Defibrillator Implantation in Patients with Nonischemic Systolic HF) trial in which 1116 patients were randomized to receive or not receive an implantable cardioverter-defibrillator. Health status was assessed by a single question of the Short-Form 36. Patients were classified as having excellent/very good, good, fair (reference) or poor health status. We assessed the association between health status and mortality using multivariable Cox proportional hazard models. Results: Self-reported health status was completed by 943 (84%) patients at randomization with a median follow-up of 67 months and a health status distribution of; excellent/very good (n = 79, 8%), good (n = 369, 39%), fair (n = 409, 43%), and poor (n = 86, 9%). All-cause mortality (death events/ 100 person-years) occurred with gradual differences according to health status from excellent/ very good (2.14), good (3.74), fair (5.21) to poor health status (5.57). The gradual difference yielded a crude hazard ratio (HR) of 0.40, 95% CI 0.20–0.80 (adjusted HR 0.47 (95% CI 0.23–0.95) for excellent/ very good health status, HR 0.71, 95% CI 0.52–0.97 (adjusted HR 0.78 (95% CI 0.56–1.08) for good health status. Poor being worse than fair health status yielded a crude HR of 1.07, 95% CI 0.67–1.69. Conclusion: Excellent/very good self-reported health status as assessed by a single question was associated with lower long-term mortality in patients with HF.

Original languageEnglish
Article number110220
JournalJournal of Psychosomatic Research
Volume137
Number of pages7
ISSN0022-3999
DOIs
Publication statusPublished - Oct 2020

    Research areas

  • And mortality, Cardiovascular disease, Health status, Heart failure, Long-term follow-up

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