Heart Failure Clinic No-show Rates And Effect On Heart Failure Hospitalizations: A Real-World Experience From The Middle East
HFSA ePoster Library. Alsindi F. 09/10/21; 343536; 298
Fahad Alsindi
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Abstract
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Introduction: Functional status is associated with poor health outcomes, including quality of life. The Short Physical Performance Battery (SPPB) is commonly used to assess functional status. However, there are limited data describing quantifiable functional status limitations in Black and Hispanic patients with stable congestive heart failure. We hypothesized that in a Black and Hispanic outpatient population with heart failure, low functional capacity, as determined by low SPPB score, would be associated with worse quality of life.
Methods: The multicenter, prospective, Screening for Cardiac Amyloidosis in Minority Populations (SCAN-MP) study identified Black and Hispanic subjects with heart failure, collected baseline characteristics, and measured SPPB. Quality of life was measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ). SPPB scores were stratified into severe functional deficit (0-6), mild functional deficit (7-9) and no functional deficit (10-12).
Results: Of 220 patients in the study, 201 (91.3%) completed the SPPB. SPPB score was associated with the overall KCCQ score and with multiple subdomains of the KCCQ, but not exclusively with physical limitation (Table 1). Patients with low SPPB scores were more likely to be older, female, have higher BMI and NYHA class, less education, more comorbidities, and worse Six-Minute Walk Test (Table 2).
Conclusion: Among Black and Hispanic outpatients with stable heart failure, stepwise decrements in functional status, as defined by the SPPB, are associated with overall KCCQ score, and scores across a variety of sub-domains. These findings suggest that targeted interventions to improve patients’ functional status could broadly benefit quality of life.
Methods: The multicenter, prospective, Screening for Cardiac Amyloidosis in Minority Populations (SCAN-MP) study identified Black and Hispanic subjects with heart failure, collected baseline characteristics, and measured SPPB. Quality of life was measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ). SPPB scores were stratified into severe functional deficit (0-6), mild functional deficit (7-9) and no functional deficit (10-12).
Results: Of 220 patients in the study, 201 (91.3%) completed the SPPB. SPPB score was associated with the overall KCCQ score and with multiple subdomains of the KCCQ, but not exclusively with physical limitation (Table 1). Patients with low SPPB scores were more likely to be older, female, have higher BMI and NYHA class, less education, more comorbidities, and worse Six-Minute Walk Test (Table 2).
Conclusion: Among Black and Hispanic outpatients with stable heart failure, stepwise decrements in functional status, as defined by the SPPB, are associated with overall KCCQ score, and scores across a variety of sub-domains. These findings suggest that targeted interventions to improve patients’ functional status could broadly benefit quality of life.
| Severe Limitations (n=65) | Mild Limitations (n=84) | No Limitations (n=52) | P value | |
| Age, mean (SD) | 73.9 (7.9) | 71.2 (8.7) | 69.6 (7.5) | 0.016 |
| Gender, n (%) | <0.001 | |||
| Male | 24 (36.9) | 51 (60.7) | 37 (71.2) | |
| Female | 41 (63.1) | 33 (39.3) | 15 (28.8) | |
| BMI, mean (SD) | 35.2 (8.2) | 32.0 (6.7) | 33.0 (7.3) | 0.030 |
| Education, n (%) | 0.016 | |||
| Less Than High School | 32 (50.0) | 22 (26.5) | 11 (21.6) | |
| High School | 23 (35.9) | 33 (39.8) | 22 (43.1) | |
| College | 6 (9.4) | 22 (26.5) | 15 (29.4) | |
| Graduate | 3 (4.7) | 4 (4.8) | 3 (5.9) | |
| Number of Comorbidities, mean (SD) | 6.5 (1.7) | 5.9 (2.0) | 5.1 (1.8) | <0.001 |
| Echo Left Ventricular Ejection Fraction, mean (SD) | 55.1 (14.0) | 58.3 (10.6) | 54.0 (11.1) | 0.106 |
| NYHA Class (%) | <0.001 | |||
| Class I | 4 (6.2) | 18 (21.7) | 15 (28.8) | |
| Class II | 28 (43.8) | 46 (55.4) | 32 (61.5) | |
| Class III | 31 (48.4) | 19 (22.9) | 5 (9.6) | |
| Class IV | 1 (1.6) | 0 (0.0) | 0 (0.0) | |
| Six-Minute Walk Test, mean (SD) | 159.6 (88.7) | 286.8 (92.0) | 360.9 (87.1) | <0.001 |
| Severe Limitations (n=65) | Mild Limitations (n =84) | No Limitations (n=52) | P value | |
| KCCQ Overall, mean (SD) | 56.2 (21.3) | 69.3 (22.5) | 75.6 (21.4) | <0.001 |
| Physical Limitation | 52.2 (26.2) | 69.7 (24.3) | 75.4 (25.9) | <0.001 |
| Symptom Stability | 50.8 (18.7) | 53.9 (22.5) | 56.7 (24.3) | 0.339 |
| Symptom Frequency | 54.6 (25.0) | 72.3 (26.3) | 77.2 (23.0) | <0.001 |
| Symptom Burden | 61.9 (26.9) | 75.9 (24.1) | 80.6 (23.2) | <0.001 |
| Self-Efficacy | 72.7 (27.0) | 76.2 (23.8) | 76.7 (28.0) | 0.637 |
| Quality of Life | 55.1 (24.9) | 65.3 (25.9) | 70.0 (24.2) | 0.005 |
| Social Limitations | 58.4 (28.6) | 67.9 (31.1) | 77.4 (26.7) | 0.005 |
Introduction: Functional status is associated with poor health outcomes, including quality of life. The Short Physical Performance Battery (SPPB) is commonly used to assess functional status. However, there are limited data describing quantifiable functional status limitations in Black and Hispanic patients with stable congestive heart failure. We hypothesized that in a Black and Hispanic outpatient population with heart failure, low functional capacity, as determined by low SPPB score, would be associated with worse quality of life.
Methods: The multicenter, prospective, Screening for Cardiac Amyloidosis in Minority Populations (SCAN-MP) study identified Black and Hispanic subjects with heart failure, collected baseline characteristics, and measured SPPB. Quality of life was measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ). SPPB scores were stratified into severe functional deficit (0-6), mild functional deficit (7-9) and no functional deficit (10-12).
Results: Of 220 patients in the study, 201 (91.3%) completed the SPPB. SPPB score was associated with the overall KCCQ score and with multiple subdomains of the KCCQ, but not exclusively with physical limitation (Table 1). Patients with low SPPB scores were more likely to be older, female, have higher BMI and NYHA class, less education, more comorbidities, and worse Six-Minute Walk Test (Table 2).
Conclusion: Among Black and Hispanic outpatients with stable heart failure, stepwise decrements in functional status, as defined by the SPPB, are associated with overall KCCQ score, and scores across a variety of sub-domains. These findings suggest that targeted interventions to improve patients’ functional status could broadly benefit quality of life.
Methods: The multicenter, prospective, Screening for Cardiac Amyloidosis in Minority Populations (SCAN-MP) study identified Black and Hispanic subjects with heart failure, collected baseline characteristics, and measured SPPB. Quality of life was measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ). SPPB scores were stratified into severe functional deficit (0-6), mild functional deficit (7-9) and no functional deficit (10-12).
Results: Of 220 patients in the study, 201 (91.3%) completed the SPPB. SPPB score was associated with the overall KCCQ score and with multiple subdomains of the KCCQ, but not exclusively with physical limitation (Table 1). Patients with low SPPB scores were more likely to be older, female, have higher BMI and NYHA class, less education, more comorbidities, and worse Six-Minute Walk Test (Table 2).
Conclusion: Among Black and Hispanic outpatients with stable heart failure, stepwise decrements in functional status, as defined by the SPPB, are associated with overall KCCQ score, and scores across a variety of sub-domains. These findings suggest that targeted interventions to improve patients’ functional status could broadly benefit quality of life.
| Severe Limitations (n=65) | Mild Limitations (n=84) | No Limitations (n=52) | P value | |
| Age, mean (SD) | 73.9 (7.9) | 71.2 (8.7) | 69.6 (7.5) | 0.016 |
| Gender, n (%) | <0.001 | |||
| Male | 24 (36.9) | 51 (60.7) | 37 (71.2) | |
| Female | 41 (63.1) | 33 (39.3) | 15 (28.8) | |
| BMI, mean (SD) | 35.2 (8.2) | 32.0 (6.7) | 33.0 (7.3) | 0.030 |
| Education, n (%) | 0.016 | |||
| Less Than High School | 32 (50.0) | 22 (26.5) | 11 (21.6) | |
| High School | 23 (35.9) | 33 (39.8) | 22 (43.1) | |
| College | 6 (9.4) | 22 (26.5) | 15 (29.4) | |
| Graduate | 3 (4.7) | 4 (4.8) | 3 (5.9) | |
| Number of Comorbidities, mean (SD) | 6.5 (1.7) | 5.9 (2.0) | 5.1 (1.8) | <0.001 |
| Echo Left Ventricular Ejection Fraction, mean (SD) | 55.1 (14.0) | 58.3 (10.6) | 54.0 (11.1) | 0.106 |
| NYHA Class (%) | <0.001 | |||
| Class I | 4 (6.2) | 18 (21.7) | 15 (28.8) | |
| Class II | 28 (43.8) | 46 (55.4) | 32 (61.5) | |
| Class III | 31 (48.4) | 19 (22.9) | 5 (9.6) | |
| Class IV | 1 (1.6) | 0 (0.0) | 0 (0.0) | |
| Six-Minute Walk Test, mean (SD) | 159.6 (88.7) | 286.8 (92.0) | 360.9 (87.1) | <0.001 |
| Severe Limitations (n=65) | Mild Limitations (n =84) | No Limitations (n=52) | P value | |
| KCCQ Overall, mean (SD) | 56.2 (21.3) | 69.3 (22.5) | 75.6 (21.4) | <0.001 |
| Physical Limitation | 52.2 (26.2) | 69.7 (24.3) | 75.4 (25.9) | <0.001 |
| Symptom Stability | 50.8 (18.7) | 53.9 (22.5) | 56.7 (24.3) | 0.339 |
| Symptom Frequency | 54.6 (25.0) | 72.3 (26.3) | 77.2 (23.0) | <0.001 |
| Symptom Burden | 61.9 (26.9) | 75.9 (24.1) | 80.6 (23.2) | <0.001 |
| Self-Efficacy | 72.7 (27.0) | 76.2 (23.8) | 76.7 (28.0) | 0.637 |
| Quality of Life | 55.1 (24.9) | 65.3 (25.9) | 70.0 (24.2) | 0.005 |
| Social Limitations | 58.4 (28.6) | 67.9 (31.1) | 77.4 (26.7) | 0.005 |
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