Associação entre qualidade de vida e prognóstico de pacientes candidatos ao transplante cardíaco de um hospital terciário do Rio de Janeiro: um estudo transversal
Associação entre qualidade de vida e prognóstico de pacientes candidatos ao transplante cardíaco de um hospital terciário do Rio de Janeiro: um estudo transversal
Data
2017
Autores
Faria, Vanessa Silveira
Journal Title
Journal ISSN
Volume Title
Publisher
Instituto Nacional de Cardiologia
Resumo
Introdução: A disponibilidade de órgãos sólidos para a realização de transplante é um problema mundial. No Brasil em 2015, foram realizados 353 transplantes cardíacos (TC), atingindo 1,7 transplantes por milhão de população. Em média, 16 pacientes morrem diariamente na fila de espera por órgãos. Este fato reforça a necessidade da estratificação de risco e avaliação da qualidade de vida (QV) dos pacientes com indicação para o TC. O estudo teve como objetivos verificar a associação entre os escores de prognóstico e a QV de pacientes candidatos ao TC; classificar os pacientes candidatos ao TC pelos escores de prognóstico do Heart
Failure Survival Score (HFSS) e do Seattle Heart Failure Model (SHFM); identificar a QV dos pacientes candidatos ao TC pelo escore do Minnesota Living With Heart Failure Questionnaire (MLHFQ) e do Kansas City Cardiomyopathy Questionnaire (KCCQ); e verificar a associação entre os escores de prognóstico do HFSS e do SHFM. Método: Estudo transversal, com 32 pacientes ambulatoriais candidatos ao TC de um hospital Terciário no Rio de Janeiro. Foram utilizados os escores de prognóstico: HFSS e SHFM e no que se refere a HRQOL, optou-se pelo MLHFQ e KCCQ. Para análise dos dados utilizou-se o coeficiente de orrelação de Pearson. Resultados: Não se verificou correlação entre escores de prognóstico (r = 0,01), e por outro lado, observou-se uma correlação forte entre os dois instrumentos de QV (r = - 0,81). Entre os escores de prognóstico e os questionários de QV a correlação foi fraca (maior valor encontrado para r = 0,21). Conclusão: A inexistência de correlação entre os escores de prognóstico pode ser explicada pela diversidade de variáveis distintas e a época da validação de cada instrumento. A correlação forte entre os escores de QV oferece subsídios na escolha de um ou outro instrumento para avaliar QV. A correlação fraca entre os escores de prognóstico e de HRQOL sugere a não associação entre os escores, ou seja, pior prognóstico não significa
pior QV e vice-versa. Sugere-se uma abordagem quantitativa e qualitativa, e a utilização conjunta dos dois escores de prognóstico com um instrumento de QV, para desta forma, aprimorar os critérios de indicação ao TC.
Introduction: The availability of solid organs for transplant is a worldwide problem. In 2015 in Brazil, 353 heart transplantation (HT) were performed, reaching 1,7 transplants per million population. About 16 patients die daily waiting for a transplant. This fact reinforces the need for risk stratification and assessment of quality of life (QOL) of patients with HT indication. The objectives of this study was to verify the association between prognostic scores and QOL of patients who are candidates for HT; to classify patients who are candidates for HT by Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM) scores; to identify QOL of patients who are candidates for HT by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and Kansas City Cardiomyopathy Questionnaire (KCCQ) and to verify the association between the prognostic scores (SHFM and HFSS). Methods: Cross-sectional study with 32 outpatients of a Tertiary hospital in Rio de Janeiro (Brazil), that are candidates for HT. The HFSS and SHFM prognostic scores were used and with reference to HRQOL, the MLHFQ and KCCQ scores were used. The Pearson Correlation Coefficient was used to data analysis. Results: There was no correlation between prognostic scores (r = 0,01). On the other hand, a strong correlation was observed between both QOL instruments (r = - 0,81). There was a weak correlation between prognostic scores and QOL questionnaires (higher value found r = 0,21). Conclusion: The absence of correlation between prognostic scores can be explained by the diversity of different variables and the validation time of each instrument. The strong correlation between QOL scores offers subsidies in the choice of the instrument to evaluate QOL. The weak correlation between the HRQOL scores and the prognostic scores suggests a non-association between the scores, i.e., worse prognosis does not mean worse quality of life and vice versa. It is suggested to consider a quantitative and qualitative approach, and the joint use of the two prognostic scores with a QOL instrument, to improve the criteria for indication of HT.
Introduction: The availability of solid organs for transplant is a worldwide problem. In 2015 in Brazil, 353 heart transplantation (HT) were performed, reaching 1,7 transplants per million population. About 16 patients die daily waiting for a transplant. This fact reinforces the need for risk stratification and assessment of quality of life (QOL) of patients with HT indication. The objectives of this study was to verify the association between prognostic scores and QOL of patients who are candidates for HT; to classify patients who are candidates for HT by Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM) scores; to identify QOL of patients who are candidates for HT by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and Kansas City Cardiomyopathy Questionnaire (KCCQ) and to verify the association between the prognostic scores (SHFM and HFSS). Methods: Cross-sectional study with 32 outpatients of a Tertiary hospital in Rio de Janeiro (Brazil), that are candidates for HT. The HFSS and SHFM prognostic scores were used and with reference to HRQOL, the MLHFQ and KCCQ scores were used. The Pearson Correlation Coefficient was used to data analysis. Results: There was no correlation between prognostic scores (r = 0,01). On the other hand, a strong correlation was observed between both QOL instruments (r = - 0,81). There was a weak correlation between prognostic scores and QOL questionnaires (higher value found r = 0,21). Conclusion: The absence of correlation between prognostic scores can be explained by the diversity of different variables and the validation time of each instrument. The strong correlation between QOL scores offers subsidies in the choice of the instrument to evaluate QOL. The weak correlation between the HRQOL scores and the prognostic scores suggests a non-association between the scores, i.e., worse prognosis does not mean worse quality of life and vice versa. It is suggested to consider a quantitative and qualitative approach, and the joint use of the two prognostic scores with a QOL instrument, to improve the criteria for indication of HT.
Description
Palavras-chave
Insuficiência cardíaca, Qualidade de vida, Transplante de coração, Quality of life, Heart transplantation, Prognosis, Heart failure
Citação
Faria VS. Associação entre qualidade de vida e prognóstico de pacientes candidatos ao transplante cardíaco de um hospital terciário do Rio de Janeiro: um estudo transversal. Rio de Janeiro. Dissertação [Mestrado Profissional em Ciências Cardiovasculares] - Instituto Nacional de Cardiologia; 2017.