Cross-classification of physical and affective symptom clusters and 180-day event-free survival in moderate to advanced heart failure

Quin E. Denfeld; Julie T. Bidwell; Jill M. Gelow; James O. Mudd; Christopher V. Chien; Shirin O. Hiatt; Christopher S. Lee

doi:10.1016/j.hrtlng.2019.11.004

Cross-classification of physical and affective symptom clusters and 180-day event-free survival in moderate to advanced heart failure

Quin E. Denfeld
, Julie T. Bidwell
, Jill M. Gelow
, James O. Mudd
, Christopher V. Chien
, Shirin O. Hiatt
, Christopher S. Lee

Research output: Contribution to journal › Article › peer-review

15 Scopus citations

Abstract

Background: The relationship between physical and affective symptom clusters in heart failure (HF) is unclear. Objectives: To identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups. Methods: This was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively. Results: In this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3%), incongruent (13.9%), and congruent-severe (16.8%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival. Conclusion: Congruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.

Original language	English (US)
Pages (from-to)	151-157
Number of pages	7
Journal	Heart and Lung
Volume	49
Issue number	2
DOIs	https://doi.org/10.1016/j.hrtlng.2019.11.004
State	Published - Mar 1 2020

Funding

Dr. Denfeld is currently supported as a Scholar of the Oregon Building Interdisciplinary Research Careers in Women's Health K12 Program funded by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (NIH) under Award Number K12HD043488. This work was supported, in part, by an award from the NIH/National Institute of Nursing Research (F31NR015936; Denfeld), an award from the American Heart Association (11BGIA7840062; Lee), and an award from the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the NIH under Award Number K12HD043488 (Lee). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the American Heart Association. Dr. Denfeld is currently supported as a Scholar of the Oregon Building Interdisciplinary Research Careers in Women's Health K12 Program funded by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (NIH) under Award Number K12HD043488. This work was supported, in part, by an award from the NIH/National Institute of Nursing Research (F31NR015936; Denfeld), an award from the American Heart Association (11BGIA7840062; Lee), and an award from the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the NIH under Award Number K12HD043488 (Lee). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the American Heart Association.

Funders	Funder number
NIH/National Institute of Nursing Research
Oregon Building Interdisciplinary Research Careers in Women's Health
Author National Institutes of Health National Institutes of Health National Institutes of Health National Institutes of Health The Bev Hartig Huntington's Disease Foundation National Institutes of Health
National Institute of Nursing Research	F31NR015936
American Heart Association/American Stroke Association	11BGIA7840062
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health	K12HD043488

Keywords

Event-free survival
Heart failure
Symptoms

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

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10.1016/j.hrtlng.2019.11.004

Cite this

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title = "Cross-classification of physical and affective symptom clusters and 180-day event-free survival in moderate to advanced heart failure",

abstract = "Background: The relationship between physical and affective symptom clusters in heart failure (HF) is unclear. Objectives: To identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups. Methods: This was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively. Results: In this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3\%), incongruent (13.9\%), and congruent-severe (16.8\%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival. Conclusion: Congruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.",

keywords = "Event-free survival, Heart failure, Symptoms",

author = "Denfeld, \{Quin E.\} and Bidwell, \{Julie T.\} and Gelow, \{Jill M.\} and Mudd, \{James O.\} and Chien, \{Christopher V.\} and Hiatt, \{Shirin O.\} and Lee, \{Christopher S.\}",

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AU - Denfeld, Quin E.

AU - Bidwell, Julie T.

AU - Gelow, Jill M.

AU - Mudd, James O.

AU - Chien, Christopher V.

AU - Hiatt, Shirin O.

AU - Lee, Christopher S.

PY - 2020/3/1

Y1 - 2020/3/1

N2 - Background: The relationship between physical and affective symptom clusters in heart failure (HF) is unclear. Objectives: To identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups. Methods: This was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively. Results: In this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3%), incongruent (13.9%), and congruent-severe (16.8%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival. Conclusion: Congruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.

AB - Background: The relationship between physical and affective symptom clusters in heart failure (HF) is unclear. Objectives: To identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups. Methods: This was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively. Results: In this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3%), incongruent (13.9%), and congruent-severe (16.8%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival. Conclusion: Congruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.

KW - Event-free survival

KW - Heart failure

KW - Symptoms

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Cross-classification of physical and affective symptom clusters and 180-day event-free survival in moderate to advanced heart failure

Abstract

Funding

Keywords

ASJC Scopus subject areas

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