The Need for Palliative Care for Patients With Chronic Heart Failure

Abstract

Aim      To assess the need for palliative medical care (PMC) in patients with chronic heart failure (CHF) depending on their body composition.

Material and methods  The study included 298 subjects (115 men and 183 women aged 61 [53; 69] years), who were divided into 5 groups based on their body composition, the presence of obesity and sarcopenia. Kaplan-Meier analysis was used to assess survival, and Cox regression was used to assess the impact of factors.

Results Analysis of the need for PMC in patients with CHF depending on body composition showed that patients with sarcopenic obesity had a shorter time to onset of indications for PMC (14.2±2.2 months; 95% confidence interval (CI) 9.8-18.5 months) compared to patients in other groups. The probability of indications for PMC significantly increased with an increase in the ratio of muscle mass index to body mass index (MMI/BMI) by 22.9 times (p<0.001); with an increase in functional class by one by 1.99 times (p<0.001); with an increase in the galectin-3 concentration by 1 ng/ml by 1.02 times (p=0.002); with a decrease in the Barthel index by 0.96 times (p<0.001); and with the presence of sarcopenia by 73% (p<0.001).

Conclusion      Patients' need for PMC is influenced by body composition, and patients with sarcopenic obesity have a shorter time to indications for PMC compared to patients with or without isolated body composition disorders.