Comprehensive symptom assessment using Integrated Palliative care Outcome Scale in hospitalized heart failure patients

Autor: Yasuhiro Hamatani, Moritake Iguchi, Yurika Ikeyama, Atsuko Kunugida, Megumi Ogawa, Natsushige Yasuda, Kana Fujimoto, Hidenori Ichihara, Misaki Sakai, Tae Kinoshita, Yasuyo Nakashima, Masaharu Akao
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: ESC Heart Failure, Vol 9, Iss 3, Pp 1963-1975 (2022)
Druh dokumentu: article
ISSN: 2055-5822
62859439
DOI: 10.1002/ehf2.13907
Popis: Abstract Aims Patients with heart failure (HF) may have variable unrecognized symptom burdens. We sought to investigate the details, determinants, and prognostic significance of symptom burden in hospitalized patients with HF. Methods and results We prospectively evaluated consecutive hospitalized patients with HF as primary diagnosis at our institution using the Integrated Palliative care Outcome Scale (IPOS) both on admission and at discharge. The IPOS, which is a well‐validated multi‐dimensional symptom assessment scale among advanced illness, consists of 17 questions for enquiring about physical symptoms (10 items), emotional symptoms (4 items) and communication and practical issues (3 items) using a 5‐point Likert scale (0 [best]–4 [worst] points). Clinically relevant symptoms were defined as ≥2 points for each IPOS item. Worsening symptom burden was defined as the total IPOS score at discharge being poorer than that on admission. Of 294 patients (mean age: 77.5 ± 12.0 years, male: 168 patients, New York Heart Association class IV: 96 patients, mean left ventricular ejection fraction [LVEF]: 44%, and median N‐terminal pro B‐type natriuretic peptide [NT‐proBNP] level: 4418 ng/L), the median (IQR) total IPOS score on admission was 19 (12, 27) and they were widely distributed (minimum: 0 – maximum: 52). The total IPOS score on admission was not correlated with the HF severity, including LVEF (Spearman's ρ = −0.05, P = 0.43), NT‐proBNP levels (Spearman's ρ = 0.08, P = 0.20) or in‐hospital mortality prediction model (GWTG‐HF risk score) (Spearman's ρ = 0.01, P = 0.90). Total IPOS scores significantly decreased during hospitalization as a whole (median [IQR]: 13 [6, 21] at discharge; P
Databáze: Directory of Open Access Journals
Externí odkaz: