Survey Spots Heart Patients in Trouble
Questionnaire Predicts Death, Heart Attacks
June 18, 2002 -- Asking heart patients simple questions about how they are feeling may be one of the best ways to predict their future. A new survey -- designed to measure how well people with heart disease are getting along in their daily lives -- accurately predicts whether they will suffer a heart attack or be hospitalized for worsening symptoms.
"We spend a lot of time in medicine doing tests to figure out who is at the highest risk so we can be more aggressive in treating those patients," he says. "Here's a simple questionnaire that could be used for a similar purpose," says John A. Spertus, MD, in a news release. Spertus created the questionnaire and is director of outcomes research at Kansas City, Missouri's Mid American Heart Institute.
More than 5,000 heart patients were asked to complete the 19-question survey known as the Seattle Angina Questionnaire (SAQ). Patients who reported the most limitations in physical activities were four times as likely to die within a year as those who had the fewest limitations.
People with severe angina -- chest pain every day -- were 60% more likely to die within a year. In general, the more the chest pain interfered with their daily lives, the more likely people were to have a heart attack or end up in the hospital over the next year.
The findings show that tools measuring patient perceptions of their symptoms and overall well-being may be just as important as expensive, high-tech tests, Spertus says.
The survey asks questions like, "How much does chest pain limit your ability to climb a flight of stairs?" and "How often do you have chest pains?" Patient responses are scored on a scale of 0 to 100, with higher scores indicating fewer physical limitations and better quality of life. Spertus says most people can answer the questions in about five minutes while waiting to see their doctor.
This study, published in the July 2 issue of Circulation: Journal of the American Heart Association, is the first to use a questionnaire to predict heart attack and death among people with heart disease. Patients were evaluated one year after completing the questionnaire.