Symptom-based clusters in patients with advanced chronic organ failure identify different trajectories of symptom variations
BACKGROUND: Healthcare needs are complex and heterogeneous in advanced chronic organ failure. However, based on symptom clusters, groups of patients with similar quality of life, care dependency and life-sustaining treatment preferences can be identified.
AIMS: To evaluate the stability of symptom-based clusters over time, and whether and to what extent the clusters are able to predict patients' 2-year survival and hospitalization rates.
METHODS: This is a secondary analysis of a longitudinal observational study including 95 outpatients with chronic obstructive pulmonary disease (COPD) GOLD stage III-IV, 80 outpatients with chronic heart failure (CHF) NYHA stage III-IV and 80 outpatients with chronic renal failure (CRF) requiring dialysis. Patients were clustered into three groups applying K-means algorithm on baseline symptoms' severity and were then longitudinally evaluated. 2-year survival and hospital admissions during 1 year were estimated using Kaplan-Meier curves and Cox models. 1-year tendencies in symptom variation, using mixed linear models, and clusters comparison over time were performed.
RESULTS: The three clusters were unable to predict patients' survival and hospital admissions. Noteworthy, they show different trajectories of symptom variation, with Cluster 1 patients experiencing a worsening of symptoms, associated with an increased care dependency, and Cluster 2 and Cluster 3 patients being stable or having a relief in some symptoms. Although Cluster 1 is becoming more similar to Cluster 2, the three clusters preserve the overall characteristics and differences.
DISCUSSION: Symptom-based clusters might help to identify patients with different trajectories of symptom variations.
CONCLUSION: Symptom clusters do not predict survival and hospital admissions and are stable over time.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
Aging clinical and experimental research - 33(2021), 2 vom: 19. Feb., Seite 419-428 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Finamore, Panaiotis [VerfasserIn] |
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| Links: |
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| Themen: |
Chronic obstructive pulmonary disease |
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| Anmerkungen: |
Date Completed 02.03.2021 Date Revised 02.03.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s40520-020-01711-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM315225440 |
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| 500 | |a Date Revised 02.03.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Healthcare needs are complex and heterogeneous in advanced chronic organ failure. However, based on symptom clusters, groups of patients with similar quality of life, care dependency and life-sustaining treatment preferences can be identified | ||
| 520 | |a AIMS: To evaluate the stability of symptom-based clusters over time, and whether and to what extent the clusters are able to predict patients' 2-year survival and hospitalization rates | ||
| 520 | |a METHODS: This is a secondary analysis of a longitudinal observational study including 95 outpatients with chronic obstructive pulmonary disease (COPD) GOLD stage III-IV, 80 outpatients with chronic heart failure (CHF) NYHA stage III-IV and 80 outpatients with chronic renal failure (CRF) requiring dialysis. Patients were clustered into three groups applying K-means algorithm on baseline symptoms' severity and were then longitudinally evaluated. 2-year survival and hospital admissions during 1 year were estimated using Kaplan-Meier curves and Cox models. 1-year tendencies in symptom variation, using mixed linear models, and clusters comparison over time were performed | ||
| 520 | |a RESULTS: The three clusters were unable to predict patients' survival and hospital admissions. Noteworthy, they show different trajectories of symptom variation, with Cluster 1 patients experiencing a worsening of symptoms, associated with an increased care dependency, and Cluster 2 and Cluster 3 patients being stable or having a relief in some symptoms. Although Cluster 1 is becoming more similar to Cluster 2, the three clusters preserve the overall characteristics and differences | ||
| 520 | |a DISCUSSION: Symptom-based clusters might help to identify patients with different trajectories of symptom variations | ||
| 520 | |a CONCLUSION: Symptom clusters do not predict survival and hospital admissions and are stable over time | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Chronic obstructive pulmonary disease | |
| 650 | 4 | |a Chronic renal failure | |
| 650 | 4 | |a Cluster analysis | |
| 650 | 4 | |a Congestive heart failure | |
| 650 | 4 | |a Dialysis | |
| 650 | 4 | |a Symptoms | |
| 700 | 1 | |a Janssen, Daisy J A |e verfasserin |4 aut | |
| 700 | 1 | |a Schols, Jos M G A |e verfasserin |4 aut | |
| 700 | 1 | |a Verstraeten, Els R N |e verfasserin |4 aut | |
| 700 | 1 | |a Antonelli Incalzi, Raffaele |e verfasserin |4 aut | |
| 700 | 1 | |a Wouters, Emiel F M |e verfasserin |4 aut | |
| 700 | 1 | |a Spruit, Martijn A |e verfasserin |4 aut | |
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