Abstract
PURPOSE: Grouping comorbidities can better reflect the intrinsic relationships among complications. We aimed to explore the relationships between comorbidity groups and dynamic changes in health-related quality of life (HRQoL) in patients with chronic heart failure (CHF). PATIENTS AND METHODS: A total of 1533 patients with CHF were included. Demographic and clinical variables were recorded during hospitalization. HRQoL was assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ) at baseline and at 3 and 12 months. Latent class analysis was used to identify comorbidity groups among patients with CHF. This method identifies latent subgroups by analyzing patterns in their comorbidities. Repeated-measures analysis of variance (ANOVA) was used to assess the relationships between comorbidity groups and dynamic changes in KCCQ scores. RESULTS: Three comorbidity clusters were identified: the young/valvular heart disease (VHD) group, the elderly/coronary heart disease (CHD) group, and the high-comorbidity burden group. The young group had a relatively lower comorbidity burden and the best HRQoL, followed by the elderly/CHD group, while the high-comorbidity burden group showed the worst HRQoL. The overall summary scores, clinical summary scores, social limitations, physical limitations, and self-efficacy were significantly highest in the high-comorbidity burden group. In addition, at 3 months the symptom scores had decreased in all three groups. Repeated-measures ANOVA showed that the comorbidity groups were significantly associated with dynamic changes in HRQoL through time and group effects. CONCLUSION: There were significant differences in the baseline characteristics and dynamic changes of HRQoL among different comorbidity clusters. Patients in the high-comorbidity burden group performed the worst in terms of quality of life, but the improvement was the most significant.