Abstract 15110: Patient Perception of Heart Failure Symptom Burden Predicts One-Year Survival
Background: Symptoms predict survival among patients with heart failure (HF) but discrepancies exist between patients’ and health providers’ perceptions of HF symptom burden. The HF Somatic Perception Scale v.3 (HFSPS) was used to examine the internal consistency, validity, and prognostic value of using a full range of 18 physical HF symptoms to predict survival.
Method: Confirmatory factor analysis of the HFSPS was conducted in a convenience sample of 366 patients with chronic HF. Convergent validity was examined using the Physical Limitation subscale of the Kansas City Cardiomyopathy Questionnaire (KCCQ). Divergent validity was examined using the Self-Care of HF index self-care management score. One-year survival based on HFSPS scores was quantified using Cox regression controlling for Seattle HF Model scores to account for variation in symptom burden secondary to clinical status, therapeutics and lab values.
Results: The sample was 61% male, 84% Caucasian, 60% functionally compromised (NYHA class III-IV) with a mean age of 57, SD13.3 years. Internal consistency of the HFSPS was α =.90. Convergent (r=-0.54, p=<0.0001) and divergent (r=0.19, p>0.05) validity were supported. Controlling for Seattle HF scores, HFSPS was a significant predictor of one-year survival with those most symptomatic having worse survival (HR=1.012 (95%CI=1.001-1.024), p=0.038).
Conclusions: Perception of HF symptom burden as measured by the HFSPS is a significant predictor of survival contributing additional prognostic value over and above objective Seattle HF Risk Model scores. This analysis suggests that assessment of a full range of HF symptoms may be useful in evaluating therapeutic outcomes and predicting survival.
- © 2013 by American Heart Association, Inc.