Cross-classification of physical and affective symptom clusters and 180-day event-free survival in moderate to advanced heart failure

BackgroundThe relationship between physical and affective symptom clusters in heart failure (HF) is unclear.ObjectivesTo identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups.MethodsThis was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively.ResultsIn this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3%), incongruent (13.9%), and congruent-severe (16.8%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival.ConclusionCongruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes