Symptom cluster profiles predict all-cause mortality among older adults with heart failure

TitleSymptom cluster profiles predict all-cause mortality among older adults with heart failure
Publication TypeReport
Year of Publication2024
AuthorsWang, Z, Walsh, S, Jeon, S, Conley, S, Chyun, D, Redeker, N
Series TitleResearch Square
KeywordsHeart Failure, Mortality, symptom cluster profiles, symptom clusters
Abstract

Background
Heart failure (HF) has a high mortality risk in older adults. Individual symptoms as predictors of mortality
in HF patients; however, symptoms often manifest in clusters, which may be more predictive of future
risks than isolated symptoms. However, research on symptom clusters in older adults who have HF is
limited. To explore the extent to which symptom cluster profiles predict all-cause mortality among older
adults with HF, while adjusting for demographic and clinical factors.
Methods
A secondary study was conducted using the data from the Health and Retirement Study. We measured
six symptoms (fatigue, shortness of breath, pain, swelling, depressive symptoms, and dizziness), and
used latent class analysis to identify baseline symptom cluster profile. We performed survival analysis
for time to death with Kaplan Meier survival analyses and Cox Proportional Hazard models.
Results
The sample included 684 participants (mean age = 74.9 (SD = 10.0) years) who demonstrated three
symptom cluster profiles (high-burden, low-burden, and cardiopulmonary-depressive). The estimated
median time-to-death was 71 (95% CI= [64, 79]) months. Participants in the high symptom burden and
respiratory-depressive distress profiles had adjusted hazard ratios of 1.48 (95% CI = 1.15, 1.94) and 1.44
(95% CI = 1.14, 1.80) for time to death compared to those in the low burden profile.
Conclusion
Symptom profiles can assist in identifying older adults with HF who are at risk for earlier mortality.
Further research is needed to determine whether alleviating these symptom clusters decreases the risk
of mortality.

DOI10.21203/rs.3.rs-4414292/v1
Citation Key14007