Anaemia,but not iron deficiency,is associated with clinical symptoms and quality of life in patients with severe heart failure and palliative home care: A substudy of the PREFER trial |
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| Institution: | 1. Research Unit, Department of Medicine, Skellefteå, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden;2. Department of Clinical chemistry, Karolinska University Hospital, Stockholm, Sweden;3. Campus Skellefteå, Department of Nursing, Umeå University, Umeå, Sweden;2. Department of Medicine, University of Otago, Christchurch, New Zealand;3. New Zealand Brain Research Institute, Christchurch, New Zealand;1. Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York;2. Division of Healthcare Delivery Science, Department of Population Health, New York University School of Medicine, New York;3. Geriatrics Section, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn;4. Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Conn;5. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn;6. Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn;7. Department of Health Policy and Management, Yale School of Public Health, New Haven, Conn;8. Center for Analytical Sciences, Yale School of Public Health, New Haven, Conn;9. Division of Geriatrics, Department of Medicine, New York University School of Medicine, New York;10. University of North Carolina, Chapel Hill;11. Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md;12. Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn;1. Section of Cardiovascular Medicine, Yale New Haven Health Bridgeport Hospital, Bridgeport, CT;2. Section of Geriatrics and Palliative Care, Yale New Haven Health Bridgeport Hospital, Bridgeport, CT;1. Department of Medicine, Duke University Medical Center, Durham, NC;2. Inova Heart and Vascular Institute, Falls Church, VA;3. Duke Clinical Research Institute, Durham, NC;4. Duke University School of Nursing, Durham, NC;5. Center for the Study of Aging and Human Development, Duke University, Durham, NC;6. Center for Health Services Research in Primary Care, Veterans Affairs Medical Center, Durham, NC;7. Dana Farber Cancer Institute, Harvard Medical School, Boston, MA;8. Sanford School of Public Policy, Duke University, Durham, NC;9. Margolis Center for Health Policy, Duke University, Durham, NC |
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| Abstract: | BackgroundTo explore the relationships between anaemia or iron deficiency (ID) and symptoms, quality of life (QoL), morbidity, and mortality.MethodsA post-hoc, non-prespecified, explorative substudy of the prospective randomized PREFER trial. One centre study of outpatients with severe HF and palliative need managed with advanced home care. Associations between anaemia, ID, and the Edmonton Symptom Assessment Scale (ESAS), Euro QoL (EQ-5D), Kansas City Cardiomyopathy Questions (KCCQ) were examined only at baseline but at 6 months for morbidity and mortality.ResultsSeventy-two patients (51 males, 21 females), aged 79.2 ± 9.1 years. Thirty-nine patients (54%) had anaemia and 34 had ID (47%). Anaemia was correlated to depression (r = 0.37; p = 0.001), anxiety (r = 0.25; p = 0.04), and reduced well-being (r = 0.26; p = 0.03) in the ESAS; mobility (r = 0.33; p = 0.005), pain/discomfort (r = 0.27; p = 0.02), and visual analogue scale of health state (r = ? 0.28; p = 0.02) in the EQ-5D; and physical limitation (r = ? 0.27; p = 0.02), symptom stability; (r = ? 0.43; p < 0.001); (r = ? 0.25; p = 0.033), social limitation;(r = ? 0.26; p = 0.03), overall summary score; (r = ? 0.24, p = 0.046) and clinical summary score; (r = ? 0.27; p = 0.02) in the KCCQ. ID did not correlate to any assessment item. Anaemia was univariably associated with any hospitalization (OR: 3.0; CI: 1.05–8.50, p = 0.04), but not to mortality. ID was not significantly associated with any hospitalization or mortality.ConclusionAnaemia, but not ID, was associated although weakly with symptoms and QoL in patients with advanced HF and palliative home care. |
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