Self-care and all-cause mortality in patients with chronic heart failure

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objectives
This study examined the association of self-care with all-cause mortality in a cohort of patients with chronic heart failure (HF).
Background
Although self-care is crucial to maintain health in patients with chronic HF, studies examining an association with clinical outcomes are scarce.
Methods
Consecutive patients with chronic HF (n = 559, mean age 66.3 ± 9.5 years, 78% men) completed the 9-item European Heart Failure Self-care Behaviour scale. Our endpoint was all-cause mortality. Associations between self-care and all-cause mortality were assessed with Kaplan-Meier analyses and multivariable Cox regression accounting for standard sociodemographic and clinical covariates, psychological distress, and self-rated health.
Results
After a median follow-up of 5.5 ± 2.4 years (range 16 weeks to 9.9 years), 221 deaths (40%) from any cause were recorded. There was no evidence of a mortality benefit in patients high over those low in global self-care (p = 0.71). In post hoc analyses, low self-reported sodium intake was associated with increased mortality (adjusted hazard ratio: 1.47; 95% confidence interval: 1.10 to 1.96; p = 0.01). Other significant predictors of mortality were: male sex, lack of a partner, New York Heart Association functional class III to IV, and increasing comorbid conditions.
Conclusions
Global self-care was not associated with long-term mortality whereas low self-reported sodium intake independently predicted increased all-cause mortality beyond parameters of disease severity. Replication of findings is needed as well as studies examining the correspondence of subjectively and objectively measured sodium intake and its effects on long-term prognosis in patients with chronic HF.
Key Words
heart failure, mortality, self-care, sodium intake, survival
Original languageEnglish
Pages (from-to)176–183
JournalJACC Heart Failure
Volume4
Issue number3
DOIs
Publication statusPublished - 2016

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@article{255594f37e124cdd9b3072bdbe090ef5,
title = "Self-care and all-cause mortality in patients with chronic heart failure",
abstract = "ObjectivesThis study examined the association of self-care with all-cause mortality in a cohort of patients with chronic heart failure (HF).BackgroundAlthough self-care is crucial to maintain health in patients with chronic HF, studies examining an association with clinical outcomes are scarce.MethodsConsecutive patients with chronic HF (n = 559, mean age 66.3 ± 9.5 years, 78{\%} men) completed the 9-item European Heart Failure Self-care Behaviour scale. Our endpoint was all-cause mortality. Associations between self-care and all-cause mortality were assessed with Kaplan-Meier analyses and multivariable Cox regression accounting for standard sociodemographic and clinical covariates, psychological distress, and self-rated health.ResultsAfter a median follow-up of 5.5 ± 2.4 years (range 16 weeks to 9.9 years), 221 deaths (40{\%}) from any cause were recorded. There was no evidence of a mortality benefit in patients high over those low in global self-care (p = 0.71). In post hoc analyses, low self-reported sodium intake was associated with increased mortality (adjusted hazard ratio: 1.47; 95{\%} confidence interval: 1.10 to 1.96; p = 0.01). Other significant predictors of mortality were: male sex, lack of a partner, New York Heart Association functional class III to IV, and increasing comorbid conditions.ConclusionsGlobal self-care was not associated with long-term mortality whereas low self-reported sodium intake independently predicted increased all-cause mortality beyond parameters of disease severity. Replication of findings is needed as well as studies examining the correspondence of subjectively and objectively measured sodium intake and its effects on long-term prognosis in patients with chronic HF.Key Wordsheart failure, mortality, self-care, sodium intake, survival",
author = "D.E.F. Kessing and J. Denollet and J.W.G.M. Widdershoven and N. Kupper",
year = "2016",
doi = "10.1016/j.jchf.2015.12.006",
language = "English",
volume = "4",
pages = "176–183",
journal = "JACC Heart Failure",
issn = "2213-1779",
publisher = "Elsevier BV",
number = "3",

}

Self-care and all-cause mortality in patients with chronic heart failure. / Kessing, D.E.F.; Denollet, J.; Widdershoven, J.W.G.M.; Kupper, N.

In: JACC Heart Failure, Vol. 4, No. 3, 2016, p. 176–183.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Self-care and all-cause mortality in patients with chronic heart failure

AU - Kessing, D.E.F.

AU - Denollet, J.

AU - Widdershoven, J.W.G.M.

AU - Kupper, N.

PY - 2016

Y1 - 2016

N2 - ObjectivesThis study examined the association of self-care with all-cause mortality in a cohort of patients with chronic heart failure (HF).BackgroundAlthough self-care is crucial to maintain health in patients with chronic HF, studies examining an association with clinical outcomes are scarce.MethodsConsecutive patients with chronic HF (n = 559, mean age 66.3 ± 9.5 years, 78% men) completed the 9-item European Heart Failure Self-care Behaviour scale. Our endpoint was all-cause mortality. Associations between self-care and all-cause mortality were assessed with Kaplan-Meier analyses and multivariable Cox regression accounting for standard sociodemographic and clinical covariates, psychological distress, and self-rated health.ResultsAfter a median follow-up of 5.5 ± 2.4 years (range 16 weeks to 9.9 years), 221 deaths (40%) from any cause were recorded. There was no evidence of a mortality benefit in patients high over those low in global self-care (p = 0.71). In post hoc analyses, low self-reported sodium intake was associated with increased mortality (adjusted hazard ratio: 1.47; 95% confidence interval: 1.10 to 1.96; p = 0.01). Other significant predictors of mortality were: male sex, lack of a partner, New York Heart Association functional class III to IV, and increasing comorbid conditions.ConclusionsGlobal self-care was not associated with long-term mortality whereas low self-reported sodium intake independently predicted increased all-cause mortality beyond parameters of disease severity. Replication of findings is needed as well as studies examining the correspondence of subjectively and objectively measured sodium intake and its effects on long-term prognosis in patients with chronic HF.Key Wordsheart failure, mortality, self-care, sodium intake, survival

AB - ObjectivesThis study examined the association of self-care with all-cause mortality in a cohort of patients with chronic heart failure (HF).BackgroundAlthough self-care is crucial to maintain health in patients with chronic HF, studies examining an association with clinical outcomes are scarce.MethodsConsecutive patients with chronic HF (n = 559, mean age 66.3 ± 9.5 years, 78% men) completed the 9-item European Heart Failure Self-care Behaviour scale. Our endpoint was all-cause mortality. Associations between self-care and all-cause mortality were assessed with Kaplan-Meier analyses and multivariable Cox regression accounting for standard sociodemographic and clinical covariates, psychological distress, and self-rated health.ResultsAfter a median follow-up of 5.5 ± 2.4 years (range 16 weeks to 9.9 years), 221 deaths (40%) from any cause were recorded. There was no evidence of a mortality benefit in patients high over those low in global self-care (p = 0.71). In post hoc analyses, low self-reported sodium intake was associated with increased mortality (adjusted hazard ratio: 1.47; 95% confidence interval: 1.10 to 1.96; p = 0.01). Other significant predictors of mortality were: male sex, lack of a partner, New York Heart Association functional class III to IV, and increasing comorbid conditions.ConclusionsGlobal self-care was not associated with long-term mortality whereas low self-reported sodium intake independently predicted increased all-cause mortality beyond parameters of disease severity. Replication of findings is needed as well as studies examining the correspondence of subjectively and objectively measured sodium intake and its effects on long-term prognosis in patients with chronic HF.Key Wordsheart failure, mortality, self-care, sodium intake, survival

U2 - 10.1016/j.jchf.2015.12.006

DO - 10.1016/j.jchf.2015.12.006

M3 - Article

VL - 4

SP - 176

EP - 183

JO - JACC Heart Failure

JF - JACC Heart Failure

SN - 2213-1779

IS - 3

ER -