Abstract
Background: Along with substantial advances in therapeutic modalities, the prevalence of heart failure (HF) is increasing. The irreversible nature of HF causes patients to face a risk of sudden deterioration and rehospitalization. Thus, the goal for HF treatment should prioritize quality of life (QOL) rather than simply prolonging survival. Previous studies noted that rehospitalizations threat HF patients' QOL. This study aimed to identify different trajectories of QOL after HF hospitalization and investigate whether QOL trajectories predicted rehospitalization.
Methods: This cohort study collected data of 480 patients with HF hospitalization, including clinical characteristics, 6-min walking distance, and MAGGIC risk score (a risk score for mortality). From discharge to 6 months after discharge, patients were interviewed with EQ5D questionnaire for QOL at five points (before discharge and at 1, 3, 5 and 6 months after discharge). Based on VAS of EQ5D, we used group-based trajectory modeling to identify and define different QOL trajectories. We categorized patients to different trajectories and analyzed the independent factors associated with rehospitalization after 6 months.
Results: Three QOL trajectories were identified: "poor" (15%), "moderate" (56.5%), and "good" (28.5%). During follow-up, rehospitalization occurred in 167 patients (34.8%). The rehospitalization rates were 43.1%, 36.5% and 27.0% in 3 trajectories, respectively. Compared to patients with a good QOL, patients with a poor or moderate QOL were older, mostly female, had higher levels of BNP and creatinine, higher MAGGIC scores and incidence of diabetes and kidney disease, but shorter 6-minute walk distance (p<0.05). The rehospitalization rate in patients with poor QOL trajectory was significantly higher than those with good QOL trajectory (OR=2.04, p=0.02). The independent factors associated with a higher risk of rehospitalization included higher BNP level (OR=1.01, p<0.001) and MAGGIC score (OR=1.06, p<0.001), and moderate or poor QOL trajectory ("moderate", OR=1.59, p=0.049; "poor", OR=2.10, p=0.021, compared to "good").
Conclusion: During the 6 months after discharge from HF hospitalization, 3 different QOL trajectories were identified. Patients with QOL trajectories of "poor" or "moderate” had high natriuretic peptide levels, MAGGIC scores, and rehospitalization rates. Tracking the changes in QOL after discharge helps with early interventions to improve the outcomes of patients at risk.
Notes
References:
Kuan,W. C., Lim, K. K., Chee, K. H., Kasim, S., Dujaili, J. A., Lee, K. K-C., Siew Li Teoh, S. L. (2024). Trajectory of health-related quality of life during and after hospitalisation due to worsening of heart failure. Quality of Life Research, 34(2), 471-484. doi: 10.1007/s11136-024-03818-6. Epub 2024 Oct 30.
Rojas, L. Z., Cabeza, L. M., Jurado, A. M., Echeverría, L. E., Hernández-Vargas, J. A., Trujillo-Cáceres, S. J. (2025). Independent predictors of quality of life in patients with chronic heart failure. Rev Fac Cien Med Univ Nac Cordoba, 82(2), 380-398. doi: 10.31053/1853.0605.v82.n2.45573.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cohort
Research Approach
Quantitative Research
Keywords:
Health Equity or Social Determinants of Health, Sub-Acute Care, Long-Term Care, Quality of Life, Heart Failure, Heart Failure Patients
Recommended Citation
Liu, Min Hui and Wang, Chao-Hung, "Trajectories of Quality of Life Predict Outcomes in Heart Failure Patients After Hospitalization" (2026). International Nursing Research Congress (INRC). 289.
https://www.sigmarepository.org/inrc/2026/presentations_2026/289
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-09-23
Trajectories of Quality of Life Predict Outcomes in Heart Failure Patients After Hospitalization
Toronto, Ontario, Canada
Background: Along with substantial advances in therapeutic modalities, the prevalence of heart failure (HF) is increasing. The irreversible nature of HF causes patients to face a risk of sudden deterioration and rehospitalization. Thus, the goal for HF treatment should prioritize quality of life (QOL) rather than simply prolonging survival. Previous studies noted that rehospitalizations threat HF patients' QOL. This study aimed to identify different trajectories of QOL after HF hospitalization and investigate whether QOL trajectories predicted rehospitalization.
Methods: This cohort study collected data of 480 patients with HF hospitalization, including clinical characteristics, 6-min walking distance, and MAGGIC risk score (a risk score for mortality). From discharge to 6 months after discharge, patients were interviewed with EQ5D questionnaire for QOL at five points (before discharge and at 1, 3, 5 and 6 months after discharge). Based on VAS of EQ5D, we used group-based trajectory modeling to identify and define different QOL trajectories. We categorized patients to different trajectories and analyzed the independent factors associated with rehospitalization after 6 months.
Results: Three QOL trajectories were identified: "poor" (15%), "moderate" (56.5%), and "good" (28.5%). During follow-up, rehospitalization occurred in 167 patients (34.8%). The rehospitalization rates were 43.1%, 36.5% and 27.0% in 3 trajectories, respectively. Compared to patients with a good QOL, patients with a poor or moderate QOL were older, mostly female, had higher levels of BNP and creatinine, higher MAGGIC scores and incidence of diabetes and kidney disease, but shorter 6-minute walk distance (p<0.05). The rehospitalization rate in patients with poor QOL trajectory was significantly higher than those with good QOL trajectory (OR=2.04, p=0.02). The independent factors associated with a higher risk of rehospitalization included higher BNP level (OR=1.01, p<0.001) and MAGGIC score (OR=1.06, p<0.001), and moderate or poor QOL trajectory ("moderate", OR=1.59, p=0.049; "poor", OR=2.10, p=0.021, compared to "good").
Conclusion: During the 6 months after discharge from HF hospitalization, 3 different QOL trajectories were identified. Patients with QOL trajectories of "poor" or "moderate” had high natriuretic peptide levels, MAGGIC scores, and rehospitalization rates. Tracking the changes in QOL after discharge helps with early interventions to improve the outcomes of patients at risk.
Description
Retrospective Cohort Study
During the 6 months after discharge from HF hospitalization, 3 trajectories of QOL were identified: "poor" (15%), "moderate" (56.5%), and "good" (28.5%). Patients with QOL trajectories of “poor” or “moderate” had high natriuretic peptide levels, MAGGIC scores, and rehospitalization rates. Tracking the changes in QOL after discharge helps with early interventions to improve the outcomes of patients at risk.