Quality of life: an index for identifying high-risk cardiac patients

A sample of 945 cardiac patients admitted under emergency conditions comple ted a quality of life questionnaire 4 months post-discharge. Half (471) wer e randomly allocated to a group used to develop a logistic regression model to predict mortality and cardiovascular morbidity 8 months later. Age 65-8 5 years, ever having heart failure. experiencing another cardiovascular eve nt since discharge, and low global quality of life (QOL) score were found t o be predictive of these outcomes an interaction between QOL and heart fail ure was also found. The model was used to formulate a risk index which was validated in the remaining 474 patients. The index defines four levels of i ncreasing risk of adverse outcomes. with rates in the development and valid ation groups, respectively, of: low risk 4% and 9%., moderate risk 13% and 15%: high risk 31% and 33%. very high risk 52% and 40%. Scores in the emoti onal. physical and social QOL domains were also found to be predictive of a dverse outcomes. suggesting that interventions in any of these areas may pr ove beneficial. The index may be useful for follow-up evaluation of cardiac patients. (C) 2001 Elsevier Science Inc. All rights reserved.