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471 VALIDATION OF THE NEW CCS SEVERITY OF ATRIAL FIBRILLATION (SAF) SCALE WITH MEASURES OF QUALITY OF LIFE SS Cvitkovic, P Dorian, CR Kerr, E Crystal, AM Gillis, PG Guerra, LB Mitchell, D Roy, AC Skanes, DG Wyse The new CCS Severity of Atrial Fibrillation (SAF) scale is intended to be used for the simple, rapid assessment and communication of the impact of AF symptoms on patient well being. This new scale has not been validated with other known scales.
Toronto, Ontario
METHODS: The CCS SAF scale is analogous to the CCS Angina scale. SAF scores range from 0 (asymptomatic) to 4 (severe impact of symptoms on quality of life (QoL) and activities of daily living). Patients in 5 Canadian centres were categorized by type of AF (paroxysmal [PAROX] vs persistent/permanent [PERM]) and rated for SAF scale by clinic personnel. All patients then completed both the Atrial Fibrillation Severity Scale (AFSS) and the SF-36 generic QoL questionnaires.
RESULTS: Enrolled were 216 outpatients with AF (54% PAROX, 46% PERM), 64 ± 12 years of age, 71% male; AF duration of 6.5 ± 6.2 years.
| SAF=0 n=45 | SAF=1 n=47 | SAF=2 n=46 | SAF=3 n=49 | SAF=4 n=29 | |
| Global Well Being (AFSS) | 8 ± 1 | 8 ± 1 | 7 ± 2 | 6 ± 2 | 5 ± 3 |
| AFSS Symptom score | 4 ± 5 | 8 ± 5 | 10 ± 8 | 13 ± 6 | 18 ± 8 |
| Social Function (SF-36) | 91 ± 19 | 85 ± 19 | 80 ± 22 | 64 ± 25 | 52 ± 28 |
| PCS* (SF-36) | 49 ± 8 | 46 ± 11 | 45 ± 10 | 41 ± 11 | 35 ± 10 |
| MCS* (SF-36) | 56 ± 5 | 52 ± 8 | 50 ± 9 | 44 ± 10 | 39 ± 14 |
There is a strong negative relationship between SAF and Global Well Being [AFSS] (r = -.482, p<.001) and a positive relationship between SAF and AFSS Symptom Score (r =.579, p<.001). There is a strong negative correlation between all SF-36 subscale and summary scores and the SAF (ranging from r = -.260 to r = -.503, all p<.001). By multivariate regression, the independent predictors of decreased Global Well Being were increasing SAF scale (p<.0001), increasing age (p=.05), and paroxysmal as opposed to persistent/permanent AF (p<.0001). Sex and AF duration were not independent predictors of well being.
CONCLUSIONS: The SAF scale is a simple and valid measure of patient well being. It accurately captures not only symptoms attributable to AF, but also physical functioning, mental health, and social functioning.
DNC