Study On Quality Of Life And Influencing Factors In Patients With Chronic Heart Failure

Objective:The aims were to understand the health-related quality of life(HRQOL)of patients with chronic heart failure(CHF),to analysis the factors affecting the quality of life(QOL)of CHF patients,to explore the relationship between related factors and QOL,and to find ways to improve the quality of life of CHF patients.Methods:A cross-sectional study was conducted using the General Information Questionnaire and the 36-item short form health survey(SF-36).From February 2017 to November 2017,195 patients with CHF who were admitted to the Department of Cardiology,Qilu Hospital,Shandong University were recruited.The patient’s fasting venous blood was collected on the second day of admission,and serum sodium(Na+),serum potassium(K+),free fatty acid(FFA),hemoglobin(HGB),N-terminal brain natriuretic peptide(NT-proBNP),and Homocysteine(Hcy)were measured.Echocardiography was performed for patients within 3 days of admission,and left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)were recorded.The collected data was analyzed by IBM SPSS 20.Result:1.The total score of SF-36 in CHF patients was 99.41±15.87,which was lower than the normal population in China.The score of Physical health components(PHC)was 47.29±8.89,and the score of mental health components(MHC)was 50.01±9.41.The higher the SF-36 total score,the better the quality of life for CHF patients.2.The total score of SF-36 in male CHF patients was higher than that in female patients(P<0.05),and the PHC score was also higher than that in female patients(P<0.01).There was no significant difference in MHC scores between genders.The PHC score in CHF patients aged<60 years was higher than that of patients aged 60 years or older(P<0.01).There was no significant difference in SF-36 scores and MHC scores between the two groups.The SF-36 score of CHF patients with ≤3 comorbidities was higher than that of comorbidities>3 Among the patients(P<0.05).There was a significant difference in PHC score between the two groups(P<0.01).There was no significant difference in the MHC scores between the two groups.The MHC scores of CHF patients without smoking were higher than those of smoking patients(P<0.01).There was asignificant difference between the two groups.There was no significant difference in the scores of SF-36 and PHC between the two groups.The PHC scores of drinking patients were higher than those without drinking(P<0.01).There was no significant difference in scores of SF-36 and MHC.Differences in SF-36 scores between normal,overweight,and obese patients were significant(P<0.01).The difference in the scores of PHC and MHC was also significant(P<0.05).There were no significant differences in SF-36 scores,PHC scores,and MHC scores among patients with different health insurance payment methods,NYHA classification,hospitalization days,duration of illness,number of hospital admissions within one year,LVEF,and LVEDD.3.The correlation analysis showed that age was significantly negatively correlated with PHC scores(P<0.01);the number of comorbidities was significantly negatively correlated with PHC scores(P<0.01).Serum potassium was significantly positively correlated with PHC scores(P<0.05)and was not significantly associated with SF-36 scores and MHC scores.FFA was significantly negatively correlated with SF-36 scores and PHC scores(P<0.01),and was not significantly associated with MHC scores.HGB was significantly positively correlated with PHC scores(P<0.01),and was not significantly associated with SF-36 scores and MHC scores.NT-proBNP was significantly positively correlated with PHC scores(P<0.01),and was no significant correlation with SF-36 scores and MHC scores.BMI was positively correlated with SF-36 scores(P<0.05),and positively correlated with PHC scores(P<0.05).No significant correlation was found between BMI with MHC scores.There was no significant correlation between hospitalization days,number of hospital admissions within one year,Hcy,LVEF,LVEDD with SF-36 scores,PHC scores and MHC scores.4.Gender,age,smoking,drinking,number of comorbidities,potassium,FFA,HGB,NT-proBNP and BMIwere defined as independent variables.SF-36 score,PHC score and MHC score were defined as dependent variables.Multiple regression analysis was conducted.FFA and BMI were the influencing factors of SF-36 scores in CHF patients.Gender,number of comorbidities and FFA were the influencing factors for PHC scores in CHF patients.Smoking and BMI were the influencing factors of MHC score.Conclusion:1.At present,the quality of life of patients with chronic heart failure in China is at a moderate level and still needs improvement.2.The quality of life of patients with chronic heart failure was significantly affected by gender,age,smoking,alcohol consumption,number of comorbidities,and body mass index.Different health care payment methods,NYHA classification,hospitalization days,duration of illness,number of hospital admissions within one year,left ventricular ejection fraction,and left ventricular end-diastolic diameter had no significant effect on the quality of life of patients with chronic heart failure.3.The quality of life in patients with chronic heart failure is related to factors such as age,number of comorbidities,serum potassium,free fatty acids,hemoglobin,NT-proBNP,and body mass index,and was no significant relationship with hospitalization days,number of hospital admissions within one year,serum sodium,homocysteine,left ventricular ejection fraction and left ventricular end diastolic diameter.4.Free fatty acids and body mass index are predictors of quality of life in patients with chronic heart failure,suggesting that lowering free fatty acid levels,improving nutritional status,and appropriate weight loss may be effective in improving the quality of life of patients with chronic heart failure.