GENDER DIFFERENCES IN 1-YEAR SURVIVAL AND QUALITY-OF-LIFE AMONG PATIENTS ADMITTED WITH CONGESTIVE-HEART-FAILURE

OBJECTIVES. Gender differences in 1-year survival and health-related q uality of life (HRQOL) among patients admitted with heart failure were determined. METHODS. Subjects of this prospective cohort study were 4 35 patients admitted nonelectively between February 2, 1993 and Februa ry 2, 1994 to an urban university hospital with shortness of breath or fatigue and evidence of heart failure on admission chest radiograph. Survival was calculated among all patients, and health-related quality of life was calculated among 259 (68%) consenting participants as mea sured by the Medical Outcomes Study Short Form-36 and Short Form-36 Ph ysical and Mental Component Summary scales. RESULTS. By 1 year, 106 (2 4%) patients had died, regardless of gender. Independent correlates of death were increasing Charlson Comorbidity Index score, initial serum sodium of 135 mmol/L or less, and white race. Among the 179 (90%) of 200 survivors who responded at all time points, health-related quality of life scores improved from admission but were still generally low, particularly among women. Even af ter adjusting for clinical and socio economic variables as well as baseline health-related quality-of-life scores, women still had less improvement at 1 year than men for the Ph ysical Component Summary scale. Women rated the quality of inpatient c are lower than men and also tended to rate the quality of follow-up ou tpatient care lower. CONCLUSIONS. One-year mortality was high and heal th-related quality of life was low in patients admitted with heart fai lure. Women had less improvement in physical health status and perceiv ed their quality of care to be lower and thus may require intervention s.