Clinical Effectiveness And Early Warning Ability Of Patient-reported Outcome For Chronic Heart Failure

Objective: To evaluate the simultaneous validity and predictive validity of Patient-reported Outcome Measure for Chronic Heart Failure(CHF-PROM).To explore the correlation of CHF-PROM each field score and total score with clinical indicators and prognostic outcomes indicators.Methods: According to the inclusion and exclusion criteria,667 inpatients with chronic heart failure were selected for CHF-PROM evaluation,and their electronic Case Rreported Form(e CRF)information was recorded.The patients were followed up by telephone one month,three months,six months,12 months and every six months thereafter.Pearson and Spearman correlation analysis were used to analyze the correlation between baseline CHF-PROM each field score and total score with simultaneous validity calibration.Selected heart failure re-hospitalization or death as predictive validity calibration,CHF-PROM each field score and total score collected during baseline and follow-up as independent variables,predictive validity was calibrated as outcome variable,combined with a single-factor and multi-factor two-level Cox model to analyze the impact of CHF-PROM each field score and total score on prognostic outcomes.Results: A total of 667 CHF patients were enrolled in this study group,of which112 were re-hospitalized with heart failure and 35 died.There were 87 patients who did not complete the follow-up and completely lost the visit,and 414 patients who completed more than one follow-up.During follow-up within 3 months of discharge,65 patients were hospitalized and 12 patients died.During the 6 months follow-up,58 patients were hospitalized and 16 died.During the follow-up of 1 year or more,41 patients were hospitalized and 11 patients died.Correlation analysis showed that CHF-PROM physiological field score was negatively correlated with NYHA classification(r=-0.306,P<0.001),NT-pro BNP(r=-0.138,P=0.002).Psychological field score was negatively correlated with NYHA classification(r=-0.096,P=0.013).CHF-PROM total score(r=-0.218,P<0.001)was negatively correlated with the NYHA classification.One-factor two-level Cox analysis showed that physiological field state improvement(P<0.001),psychological field state improvement(P=0.004)can reduce the risk of re-hospitalization.Multivariate two-level Cox analysis revealed that patients with increased score in the physiological field had a lower risk of heart failure re-hospitalization(P=0.005)or death(P=0.036).Conclusion: CHF-PROM and its physiological and psychological field score can objectively quantify the severity of chronic heart failure patients,identify the risk of re-hospitalization and death,have a good correlation of clinical indicators and early warning ability of outcome,can be used in the clinical management of chronic heart failure patients.There was no significant correlation of social and therapeutic field with clinical calibration and prognostic outcome calibration.