Is health-related quality of life an independent predictor of survival in patients with chronic heart failure?

Abstract Objective The aim of this study was to examine whether the physical and mental components of health-related quality of life (HRQoL) are independent predictors of survival in patients with chronic heart failure (CHF). Methods A cohort of 231 outpatients with CHF was followed prospectively for 986 days (median; interquartile range=664–1120). Generic HRQoL was measured with the Short Form-36 Health Survey (SF-36), disease-specific HRQoL was measured with the Kansas City Cardiomyopathy Questionnaire, and depression was measured with the self-reported Patient Health Questionnaire. Results Both generic and disease-specific HRQoL were predictive of survival on univariate analyses. After adjustment for prognostic factors such as age, gender, degree of left ventricular dysfunction, and functional status, only the mental health component of SF-36 and the disease-specific HRQoL remained significant. When depression was included, both measures also lost their predictive power. Conclusion Our data suggest that the prognostic value of patients' HRQoL reflects confounding with the severity of disease and comorbid depression.