PMID- 30541443 OWN - NLM STAT- MEDLINE DCOM- 20190815 LR - 20231004 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 18 IP - 1 DP - 2018 Dec 12 TI - Validation of heart failure quality of life tool and usage to predict all-cause mortality in acute heart failure in Uganda: the Mbarara heart failure registry (MAHFER). PG - 232 LID - 10.1186/s12872-018-0959-1 [doi] LID - 232 AB - BACKGROUND: The health-related quality of life (HRQoL) is an important treatment goal that could serve as low-cost prognostication tool in resource poor settings. We sought to validate the Kansas City Cardiomyopathy Questionnaire (KCCQ) and evaluate its use as a predictor of 3 months all-cause mortality among heart failure participants in rural Uganda. METHODS: The Mbarara Heart Failure Registry Cohort study observes heart failure patients during hospital stay and in the community in rural Uganda. Participants completed health failure evaluations and HRQoL questionnaires at enrollment, 1 and 3 months of follow-up. We used Cronbach's alpha coefficients to define internal consistency, intraclass correlation coefficients as a reliability coefficient, and Cox proportional hazard models to predict the risk of 3 months all-cause mortality. RESULTS: Among the 195 participants who completed HRQoL questionnaires, the mean age was 52 (standard deviation (SD) 21.4) years, 68% were women and 29% reported history of hypertension. The KCCQ had excellent internal consistency (87% Cronbach alpha) but poor reliability. Independent predictors of all-cause mortality within 3 months included: worse overall KCCQ score (Adjusted Hazard ratio (AHR) 2.9, 95% confidence interval (CI) 1.1, 8.1), highest asset ownership (AHR 3.6, 95% CI 1.2, 10.8), alcoholic drinks per sitting (AHR per 1 drink 1.4, 95% CI 1.0, 1.9), New York Heart Association (NYHA) functional class IV heart failure (AHR 2.6, 95% CI 1.3, 5.4), estimated glomerular filtration rate (eGFR) 30 to 59 ml/min/1.73 m(2) (AHR 3.4, 95% CI 1.1, 10.8), and eGFR less than 15 ml/min/1.73 m(2) (AHR 2.7, 95% CI 1.0, 7.1), each 1 pg/mL increase in Brain Natriuretic Peptide (BNP) (AHR, 1.0, 95% CI 1.0, 1.0), and each 1 ng/mL increase in Creatine-Kinase MB isomer (CKMB) (AHR 1.0, 95% CI 1.0, 1.1). CONCLUSION: The KCCQ showed excellent internal consistency. Worse overall KCCQ score, highest asset ownership, increasing alcoholic drink per sitting, NYHA class IV, decreased estimated glomerular filtration rate, BNP, and CKMB predicted all-cause mortality at 3 months. The KCCQ could be an additional low-cost tool to aid in the prognostication of acute heart failure patients. FAU - Okello, Samson AU - Okello S AUID- ORCID: 0000-0001-7377-6094 AD - Department of Internal Medicine, Mbarara University of Science and Technology, P. O Box 1410, Mbarara, Uganda. okello.samson@must.ac.ug. AD - Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA. okello.samson@must.ac.ug. AD - Bernard Lown Scholars in Cardiovascular Health Program, Department of Global Health and Populations, Harvard T.H Chan School of Public Health, Boston, MA, USA. okello.samson@must.ac.ug. FAU - Abeya, Fardous Charles AU - Abeya FC AD - Department of Internal Medicine, Mbarara University of Science and Technology, P. O Box 1410, Mbarara, Uganda. FAU - Lumori, Boniface Amanee Elias AU - Lumori BAE AD - Department of Internal Medicine, Mbarara University of Science and Technology, P. O Box 1410, Mbarara, Uganda. FAU - Akello, Suzan Joan AU - Akello SJ AD - Department of Educational Foundations and Psychology, Mbarara University of Science and Technology, Mbarara, Uganda. FAU - Moore, Christopher Charles AU - Moore CC AD - Department of Internal Medicine, Mbarara University of Science and Technology, P. O Box 1410, Mbarara, Uganda. AD - Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA. FAU - Annex, Brian H AU - Annex BH AD - Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA. FAU - Buda, Andrew J AU - Buda AJ AD - Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA. LA - eng GR - K43 TW010715/TW/FIC NIH HHS/United States PT - Journal Article PT - Observational Study PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Validation Study DEP - 20181212 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 MH - Adult MH - Aged MH - *Decision Support Techniques MH - Female MH - Heart Failure/*diagnosis/*mortality/physiopathology/psychology MH - Hospitalization MH - Humans MH - Life Style MH - Male MH - Middle Aged MH - Predictive Value of Tests MH - Prognosis MH - *Quality of Life MH - Registries MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Rural Health MH - Social Determinants of Health MH - Socioeconomic Factors MH - *Surveys and Questionnaires MH - Time Factors PMC - PMC6291962 OTO - NOTNLM OT - 36-item short form health survey OT - Acute heart failure OT - All-cause mortality OT - Kansas City cardiomyopathy questionnaire OT - Sub-Saharan Africa COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The ethical review boards at the Mbarara University of Science and Technology (number: 26/11-14), the University of Virginia Health System, and the Uganda National Council of Science and Technology (number: HS2024) approved the conduct of this study. All participants signed a written informed consent prior to study participation. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/12/14 06:00 MHDA- 2019/08/16 06:00 PMCR- 2018/12/12 CRDT- 2018/12/14 06:00 PHST- 2018/08/07 00:00 [received] PHST- 2018/11/19 00:00 [accepted] PHST- 2018/12/14 06:00 [entrez] PHST- 2018/12/14 06:00 [pubmed] PHST- 2019/08/16 06:00 [medline] PHST- 2018/12/12 00:00 [pmc-release] AID - 10.1186/s12872-018-0959-1 [pii] AID - 959 [pii] AID - 10.1186/s12872-018-0959-1 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2018 Dec 12;18(1):232. doi: 10.1186/s12872-018-0959-1.