Gender Differences in 1-Year Survival and Quality of Life Among Patients Admitted With Congestive Heart Failure

Abstract

Gender differences in 1-year survival and health-related quality of life (HRQOL) among patients admitted with heart failure were determined. Subjects of this prospective cohort study were 435 patients admitted nonelectively between February 2, 1993 and February 2, 1994 to an urban university hospital with shortness of breath or fatigue and evidence of heart failure on admission chest radiograph. Survival was calculated among all patients, and health-related quality of life was calculated among 259 (68%) consenting participants as measured by the Medical Outcomes Study Short Form-36 and Short Form-36 Physical and Mental Component Summary scales. By 1 year, 106 (24%) patients had died, regardless of gender. Independent correlates of death were increasing Charlson Comorbidity Index score, initial serum sodium of 135 mmol/L or less, and white race. Among the 179 (90%) of 200 survivors who responded at all time points, health-related quality of life scores improved from admission but were still generally low, particularly among women. Even after adjusting for clinical and socioeconomic variables as well as baseline health-related quality-of-life scores, women still had less improvement at 1 year than men for the Physical Component Summary scale. Women rated the quality of inpatient care lower than men and also tended to rate the quality of follow-up out-patient care lower. One-year mortality was high and health-related quality of life was low in patients admitted with heart failure. Women had less improvement in physical health status and perceived their quality of care to be lower and thus may require interventions.