Cover: Physical Functioning and Mental Well-Being in Association with Health Outcome in Patients Enrolled in the Multicenter Automatic Defibrillator Implantation Trial II

Physical Functioning and Mental Well-Being in Association with Health Outcome in Patients Enrolled in the Multicenter Automatic Defibrillator Implantation Trial II

Published in: European Heart Journal, v. 28, no. 5, Mar. 2007, p. 601-607

Posted on rand.org 2007

by Katarzyna Piotrowicz, Katia Noyes, Jeffrey M. Lyness, Scott McNitt, Mark L. Andrews, Andrew W. Dick, W. Jackson Hall, Arthur J. Moss, Wojciech Zareba

AIMS: The association of psychosocial and physical factors with health outcome in patients with congestive heart failure (CHF) has not been fully explored. The aim of this study was to assess the physical and mental health in relationship to health outcome in post-infarction patients with advanced left ventricular dysfunction. METHODS AND RESULTS: A total of 1058 patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) completed the Medical Outcome Trust Short Form (SF-12) at baseline. Physical component summary (PCS) and mental component summary (MCS) of SF-12 were analysed in relationship to survival, hospitalization due to CHF, and implantable cardioverter-defibrillator (ICD) therapy. Both baseline PCS and MCS were significantly associated with death (P < 0.001 and P < 0.016, respectively) and hospitalization due to CHF (P 0.001). After adjustment for significant clinical covariates and treatment group, low PCS and low MCS groups remained significant predictors of mortality and CHF hospitalization. Neither PCS nor MCS was associated with appropriate ICD therapy for ventricular tachyarrhythmias. Patients who experienced appropriate ICD shocks had a statistically significant deterioration of PCS but not MCS from baseline to 12 months. CONCLUSION: Lower baseline PCS and MCS are associated with unfavourable health outcome in MADIT II patients, but not with appropriate ICD therapy for ventricular tachyarrhythmias. Patients who experience ICD shock reported a decrease in PCS, but little or no changes in MCS.

This report is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.