The relationship between self-care, long-term mortality, and heart failure hospitalization: insights from a real-world cohort study

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• dc.contributor.author Calero Molina, Esther
• dc.contributor.author Hidalgo, Encarnacion
• dc.contributor.author Rosenfeld, Laia
• dc.contributor.author Verdú-Rotellar, José María
• dc.contributor.author Verdú Soriano, Jose
• dc.contributor.author Garay, Alberto
• dc.contributor.author Alcoberro, Lidia
• dc.contributor.author Jiménez Marrero, Santiago
• dc.contributor.author Garcimartín Cerezo, Paloma
• dc.contributor.author Yun, Sergi
• dc.contributor.author Guerrero, Carmen
• dc.contributor.author Moliner Borja, Pedro
• dc.contributor.author Delso, Cristina
• dc.contributor.author Alcober, Laia
• dc.contributor.author Enjuanes Grau, Cristina
• dc.contributor.author Comín Colet, Josep
• dc.date.accessioned 2021-09-14T06:42:28Z
• dc.date.issued 2022
• dc.description.abstract Aims: The assumption that improved self-care in the setting of heart failure (HF) care necessarily translates into improvements in long-term mortality and/or hospitalization is not well established. We aimed to study the association between self-care and long-term mortality and other major adverse HF events (MAHFE). Methods and results: We conducted an observational, prospective, cohort study of 1123 consecutive patients with chronic HF. The primary endpoint was all-cause mortality. We used the European Heart Failure Self-care Behaviour Scale 9-item version (EHFSCBS-9) to measure global self-care (overall score) and three specific dimensions of self-care including autonomy-based adherence, consulting behaviour and provider-based adherence. After a mean follow-up of 3.3 years, all-cause death occurred in 487 patients (43%). In adjusted analysis, higher EHFScBS-9 scores (better self-care) at baseline were associated with lower risk of all-cause death [hazard ratio (HR) 0.993, 95% confidence interval (CI) (0.988-0.997), P-value = 0.002], cardiovascular (CV) death [HR 0.989, 95% CI (0.981-0.996), P-value = 0.003], HF hospitalization [HR 0.993, 95% CI (0.988-0.998), P-value = 0.005], and the combination of MAHFE [HR 0.995, 95% CI (0.991-0.999), P-value = 0.018]. Similarly, impaired global self-care [HR 1.589, 95% CI (1.201-2.127), P-value = 0.001], impaired autonomy-based adherence [HR 1.464, 95% CI (1.114-1.923), P-value = 0.006], and impaired consulting behaviour dimensions [HR 1.510, 95% CI (1.140-1.923), P-value = 0.006] were all associated with higher risk of all-cause mortality. Conclusion: In this study, we have shown that worse self-care is an independent predictor of long-term mortality (both, all-cause and CV), HF hospitalization, and the combinations of these endpoints in patients with chronic HF. Important dimensions of self-care such as autonomy-based adherence and consulting behaviour also determine the risk of all these outcomes in the long term.
• dc.format.mimetype application/pdf
• dc.identifier.citation Calero-Molina E, Hidalgo E, Rosenfeld L, Verdú-Rotellar JM, Verdú-Soriano J, Garay A, Alcoberro L, Jimenez-Marrero S, Garcimartin P, Yun S, Guerrero C, Moliner P, Delso C, Alcober L, Enjuanes C, Comin-Colet J. The relationship between self-care, long-term mortality, and heart failure hospitalization: insights from a real-world cohort study. Eur J Cardiovasc Nurs. 2022;21(2):116-26. DOI: 10.1093/eurjcn/zvab011
• dc.identifier.doi http://dx.doi.org/10.1093/eurjcn/zvab011
• dc.identifier.issn 1474-5151
• dc.identifier.uri http://hdl.handle.net/10230/48446
• dc.language.iso eng
• dc.publisher Oxford University Press
• dc.relation.ispartof Eur J Cardiovasc Nurs. 2022;21(2):116-26
• dc.rights © Oxford University Press. This is a pre-copyedited, author-produced version of an article accepted for publication in European journal of cardiovascular nursing following peer review. The version of record Calero-Molina E, Hidalgo E, Rosenfeld L, Verdú-Rotellar JM, Verdú-Soriano J, Garay A, Alcoberro L, Jimenez-Marrero S, Garcimartin P, Yun S, Guerrero C, Moliner P, Delso C, Alcober L, Enjuanes C, Comin-Colet J. The relationship between self-care, long-term mortality, and heart failure hospitalization: insights from a real-world cohort study. Eur J Cardiovasc Nurs. 2022;21(2):116-26. DOI: 10.1093/eurjcn/zvab011 is available online at: http://dx.doi.org/10.1093/eurjcn/zvab011
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword European self-care behaviour scale
• dc.subject.keyword HF hospitalization
• dc.subject.keyword Heart failure
• dc.subject.keyword Mortality
• dc.subject.keyword Outcomes
• dc.subject.keyword Self-care
• dc.title The relationship between self-care, long-term mortality, and heart failure hospitalization: insights from a real-world cohort study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion