JMIR Publications

ABSTRACT

Background:

Heart failure (HF) decompensation is a major driver of hospitalisations and represents a significant burden to the health care system. Identifying those at greatest risk of admission can allow for targeted interventions to reduce this risk.

Objective:

To compare the predictive value of objective and subjective HF symptoms on imminent HF decompensation and subsequent hospitalisation within a 30-day period.

Methods:

A prospective observational pilot study was conducted. People living at home with HF were recruited from a single-centre HF outpatient clinic. Objective (blood pressure, heart rate, weight, B-type Natriuretic Peptide) and subjective (four HF symptoms, scored for severity on a 5-point Likert scale) were collected twice weekly for a 30-day period.

Results:

A total of 29 participants (median age 79 years, 62% male) completed the study. Ten participants (34.5%) were hospitalised as a result of HF during the study period. For objective data, only heart rate exhibited a between group difference, however was non-significant for variability (P = 0.71). Subjective symptom scores provided better prediction, specifically the highest precision of HF hospitalisation was observed when HF patients experienced severe dyspnoea, orthopnoea and benopnoea on any given day (AUC 0.77, sensitivity 83%, specificity 73%).

Conclusions:

The use of subjective symptom reporting on a 5-point Likert scale provides a simple and low cost predication of HF decompensation and imminent hospitalisation risk. The collection of symptom data could be augmented by the use of ecological momentary assessment of self-reported symptoms collected via mobile health (mHealth).