Signs of congestion, quality of life and short‐term rehospitalization in patients with heart failure
Abstract Aims Signs of congestion are a treatment target in patients with heart failure (HF), as they affect patients' well‐being, and congestion scores are associated with the risk of early readmission. However, which individual sign of congestion has the strongest association with quality of...
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| Format: | Article |
| Language: | English |
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Wiley
2025-08-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15277 |
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| author | Geert H.D. Voordes Adriaan A. Voors Hailun Qin Jozine M. terMaaten Kevin Damman |
| author_facet | Geert H.D. Voordes Adriaan A. Voors Hailun Qin Jozine M. terMaaten Kevin Damman |
| author_sort | Geert H.D. Voordes |
| collection | DOAJ |
| description | Abstract Aims Signs of congestion are a treatment target in patients with heart failure (HF), as they affect patients' well‐being, and congestion scores are associated with the risk of early readmission. However, which individual sign of congestion has the strongest association with quality of life (QoL) and HF rehospitalization remains uncertain. Methods and Results We included 1551 HF patients hospitalized for worsening HF. QoL was assessed using the Kansas City Cardiomyopathy Questionnaire‐23 (KCCQ‐23) on the same day as physical examination. We performed linear and Cox regression to find associations of signs of HF to QoL and 60 day HF rehospitalization. All analyses were externally validated in a similar independent cohort. Patients with worse QoL were older and more often female and had more comorbidities and signs of HF. In multivariable regression analyses, peripheral oedema and orthopnoea (standardized beta −0.210, P < 0.001 and standardized beta −0.206, P < 0.001, respectively) had the strongest association with worse QoL. Elevated jugular venous pressure (JVP) was the only multivariable adjusted congestive sign associated with a higher risk of 60 day HF rehospitalization [hazard ratio (HR) 1.64 (1.03–2.60), P = 0.038]. QoL was significantly associated with 60 day HF rehospitalization [HR 1.09 (1.04–1.14), per 5‐unit Kansas City Cardiomyopathy Questionnaire (KCCQ) decrease; P < 0.001]. The presence or absence of signs of congestion did not modify the association between QoL and 60 day HF rehospitalization. Conclusions Peripheral oedema and orthopnoea showed the strongest association with QoL in patients admitted for HF. JVP had the strongest association with the risk of 60 day rehospitalization. Clinically, it is important to distinguish between individual signs due to the discrepancy of their impact on outcome. |
| format | Article |
| id | doaj-art-719e625f17214a5484bb186e3a1c898b |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-719e625f17214a5484bb186e3a1c898b2025-08-20T03:51:44ZengWileyESC Heart Failure2055-58222025-08-011242477248610.1002/ehf2.15277Signs of congestion, quality of life and short‐term rehospitalization in patients with heart failureGeert H.D. Voordes0Adriaan A. Voors1Hailun Qin2Jozine M. terMaaten3Kevin Damman4Department of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsDepartment of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsDepartment of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsDepartment of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsDepartment of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsAbstract Aims Signs of congestion are a treatment target in patients with heart failure (HF), as they affect patients' well‐being, and congestion scores are associated with the risk of early readmission. However, which individual sign of congestion has the strongest association with quality of life (QoL) and HF rehospitalization remains uncertain. Methods and Results We included 1551 HF patients hospitalized for worsening HF. QoL was assessed using the Kansas City Cardiomyopathy Questionnaire‐23 (KCCQ‐23) on the same day as physical examination. We performed linear and Cox regression to find associations of signs of HF to QoL and 60 day HF rehospitalization. All analyses were externally validated in a similar independent cohort. Patients with worse QoL were older and more often female and had more comorbidities and signs of HF. In multivariable regression analyses, peripheral oedema and orthopnoea (standardized beta −0.210, P < 0.001 and standardized beta −0.206, P < 0.001, respectively) had the strongest association with worse QoL. Elevated jugular venous pressure (JVP) was the only multivariable adjusted congestive sign associated with a higher risk of 60 day HF rehospitalization [hazard ratio (HR) 1.64 (1.03–2.60), P = 0.038]. QoL was significantly associated with 60 day HF rehospitalization [HR 1.09 (1.04–1.14), per 5‐unit Kansas City Cardiomyopathy Questionnaire (KCCQ) decrease; P < 0.001]. The presence or absence of signs of congestion did not modify the association between QoL and 60 day HF rehospitalization. Conclusions Peripheral oedema and orthopnoea showed the strongest association with QoL in patients admitted for HF. JVP had the strongest association with the risk of 60 day rehospitalization. Clinically, it is important to distinguish between individual signs due to the discrepancy of their impact on outcome.https://doi.org/10.1002/ehf2.15277heart failurecongestionquality of liferehospitalizationsigns and symptomsbiomarkers |
| spellingShingle | Geert H.D. Voordes Adriaan A. Voors Hailun Qin Jozine M. terMaaten Kevin Damman Signs of congestion, quality of life and short‐term rehospitalization in patients with heart failure ESC Heart Failure heart failure congestion quality of life rehospitalization signs and symptoms biomarkers |
| title | Signs of congestion, quality of life and short‐term rehospitalization in patients with heart failure |
| title_full | Signs of congestion, quality of life and short‐term rehospitalization in patients with heart failure |
| title_fullStr | Signs of congestion, quality of life and short‐term rehospitalization in patients with heart failure |
| title_full_unstemmed | Signs of congestion, quality of life and short‐term rehospitalization in patients with heart failure |
| title_short | Signs of congestion, quality of life and short‐term rehospitalization in patients with heart failure |
| title_sort | signs of congestion quality of life and short term rehospitalization in patients with heart failure |
| topic | heart failure congestion quality of life rehospitalization signs and symptoms biomarkers |
| url | https://doi.org/10.1002/ehf2.15277 |
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