[Quality of life, depression and cognitive functions 4. Quality of life]

Aim of this paper is to explore and quanti-quantitatively assess whether QoL as measured with the Kansas City Cardiomiopathy Questionnaire (KCCQ) summary score could be considered as an independent relevant component of clinical prognostic score of morbidity and mortality and identify patients at risk for death or admissions.

Sixty-three per cent NYHA II and 39.4% NYHA III-IV patients experience a good Qol (score > 75). Risk factors for "not good" (< 75) QoL are age, NYHA class III-IV, diabetes, COPD and previous hospitalizations. NYHA II and III-IV patients with not good QoL experience an higher mortality than patients with a good QoL in the same classes. NYHA II patients with not good QoL experience the same 1 year readmission rates as NYHA III-IV patients with good QoL.

Quality of life scores identify patients with different risk of mortality and readmissions within the same NYHA class. The prognostic value of KCCQ summary scores could identify candidates for disease management in whom better targeted care strategies may reduce hospitalizations and prevent deaths.