1. LOW ONE-YEAR MORTALITY IN CHRONIC HEART FAILURE: ROLE OF THE
CAMPUS LIVING WITH HEART FAILURE SOFTWARE
FOR ASSESSMENT OF QUALITY OF LIFE
IN A HYBRID SERVICE WITH
CLINICAL-BASED FOLLOW-UP
PLUS HOSPITAL READMISSION. 
GP. CARBONI, R. BOTTI, C. GOFFREDO, T.PETITTI.
Università Campus Bio-medico, Roma (I).

2. The explanation for the poor prognosis of unselected patients (pts)
with Chronic Heart Failure (CHF)
is still undefined.
We have thus followed-up for 1 year
100 consecutive pts with CHF.
Campus Bio-Medico University of Rome

3. according to the ACC/AHA guidelines for the evaluation and management
All pts were medically treated
according to the ACC/AHA guidelines
for the evaluation and management
of CHF in the adult:
Circulation 2001;
Campus Bio-Medico University of Rome

4. Variations in Functional (F), Psychological (P),
Social life (S), and Therapy Compliance (TC)
areas were evaluated with a
previously validated software
“The Campus Living with Heart Failure Software”
(CLHFS) , in all pts.
Campus Bio-Medico University of Rome

5. Via Longoni, 83 - 00155 Roma (Italy) E-Mail: g. carboni@unicampus
Via Longoni, Roma (Italy) Tel (+39) 06/ Fax (+39) 06/

6. Alterations in F , P , S and TC of such patients
were calculated and scored by an
interview with 32 graded questions,
and were then expressed as
a percentage reduction
from the values previously observed
in 50 control pts.
Campus Bio-Medico University of Rome

7. Selected patients: 100
Functional Area (F)
Psychological Area (P)
Social Life Area (S)
Compliance With Therapy (TC)
59 ± 13 %
42 ± 16 %
38 ± 32 %
24 ± 19 %
Age : 69 ± 10 NYHA class : 3 ± 1 Canadian Class : - EF : 36 ± 12 % (Mean ± SD)
% Impairment
Distress evolution
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8. Patient's self rating Relatives perception
of distress
Relatives perception
of patient's distress
close
100 90 80 70 60 50 40 30 20 10
100 90 80 70 60 50 40 30 20 10
Level of maximum distress
Level of minimum distress

9. Functional Area (% Impairment in 3 sub - Areas)
39 %
53 %
61 %
Perception of HF Status
Funcional capacity
Perception of organ damage
due to HF
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10. Psychological Area (% Impairment in 4 sub - Areas)
43 %
32 %
37 %
25 %
Coping with therapy
Global health status
Energy level status
Mental health
status

11. Social Life Area (% Impairment in 2 sub - Areas)
47 %
40 %
Limitation in social life due
to physical inability
Limitation in social life due
to emotional status
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12. Patient's self rating Relatives perception
of distress 52 ± 28
Relatives perception
of patient's distress 50 ± 29
close
100 90 80 70 60 50 40 30 20 10
100 90 80 70 60 50 40 30 20 10
Level of maximum distress
Level of minimum distress

13. A reverse statistically correlation among the high distress
burden and the low QOL level was observed
(r > 0.8, P < 0.001, for all values)
but not for EF ( r < 3, p = ns).
Campus Bio-Medico University of Rome

14. In 1-year follow-up, all pts were seen
in a dedicated clinic for CHF for at least 4 times
as out-patients while only 40% of them had
a repeated admission in Hospital
with an average number of 2 ±2 readmissions.
Campus Bio-Medico University of Rome

15. Combined counseling on QOL and TC
and repeated hospital admissions may have
had thus a role in favouring rational
variations in the therapeutical strategy in
pts under study.
Such a complex methodology was followed by
a favourable outcome in pts under study
since 1-year mortality ratio was only of 2%.
Campus Bio-Medico University of Rome

16. This favourable outcome is consistently low
when compared with data from literature.
The use of the CLHFS is rapid
(it takes less than 10 min to complete it ) and it is
a useful instrument for nursing counseling
when combined to classic medical therapy
in a hybrid service consisting in clinical-based
follow-up plus hospital
readmissions in case of pts instability.
Campus Bio-Medico University of Rome