Trine Bernholdt Rasmussen1, Ann-Dorthe Zwisler2, Lau Caspar Thygesen3, Henning Bundgaard4, Philip Moons5, Selina Kikkenborg Berg6. 1. The Heart Centre (Section 2151), Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen O, Denmark; Department of Cardiology (Section SA-835), Herlev and Gentofte University Hospital, Kildegårdsvej 28, 2900 Hellerup, Denmark. Electronic address: trine.bernholdt.rasmussen@regionh.dk. 2. National Centre of rehabilitation and palliation, University of Southern Denmark, Vestergade 17, 5800 Nyborg, Denmark. Electronic address: ann.dorthe.olsen.zwisler@rsyd.dk. 3. National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen K, Denmark. Electronic address: lct@si-folkesundhed.dk. 4. The Heart Centre (Section 2151), Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen O, Denmark. Electronic address: henning.bundgaard@regionh.dk. 5. KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, blok D, box 7001, 3000 Leuven, Belgium; Institute of Health and Care Science, University of Gothenburg, Arvid Wallgrens backe 20, 41346 Gothenburg, Sweden. Electronic address: philip.Moons@med.kuleuven.be. 6. The Heart Centre (Section 2151), Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen O, Denmark. Electronic address: selina.kikkenborg.berg.01@regionh.dk.
Abstract
BACKGROUND: Infective endocarditis (IE) is a severe disease requiring lengthy hospitalisation. Little is known about patients' recovery after IE. The aims of this study in IE patients were; (i) to describe mortality, readmission, self-reported health and rehabilitation up to 1year post-discharge, (ii) to examine associations between self-reported health and readmission, and (iii) to investigate predictors of readmission and mortality. METHODS: All adults treated for IE in Denmark, January-June 2011 (N=347), were followed in registers. Eligible individuals (n=209) were invited to participate in a questionnaire survey (responders n=122). Responses were compared with those of a background reference population and a heart valve surgery population. Mortality and readmission data from registers 12months post-discharge were investigated. RESULTS: Patients discharged after treatment for IE had a mortality of 18% (95% confidence interval (CI): 14%-23%) one year post-discharge and 65% (95% CI: 59%-71%) had been readmitted, the majority (82%) acutely. Patients had lower self-reported health compared to the background population (physical component scale (PCS); mean (standard deviation (SD)): 42.2 (11.1) vs. 47.1 (12.1), (p=0.0004), mental component scale (MCS); 50.1 (11.7) vs. 53.8 (9.2), (p=0.006), and more were sedentary (29 vs. 15%), (p=0.002). Large proportions had clinical signs of anxiety and depression, 25% and 22% respectively, exceeding a hospital anxiety and depression scale (HADS) cut-off score of 8. Almost half (47%) had not been offered cardiac rehabilitation (CR). CONCLUSIONS: After IE, mortality and readmission rates were high and self-reported physical and mental health poor. These findings call for changes in in-hospital and post-discharge management.
BACKGROUND: Infective endocarditis (IE) is a severe disease requiring lengthy hospitalisation. Little is known about patients' recovery after IE. The aims of this study in IE patients were; (i) to describe mortality, readmission, self-reported health and rehabilitation up to 1year post-discharge, (ii) to examine associations between self-reported health and readmission, and (iii) to investigate predictors of readmission and mortality. METHODS: All adults treated for IE in Denmark, January-June 2011 (N=347), were followed in registers. Eligible individuals (n=209) were invited to participate in a questionnaire survey (responders n=122). Responses were compared with those of a background reference population and a heart valve surgery population. Mortality and readmission data from registers 12months post-discharge were investigated. RESULTS:Patients discharged after treatment for IE had a mortality of 18% (95% confidence interval (CI): 14%-23%) one year post-discharge and 65% (95% CI: 59%-71%) had been readmitted, the majority (82%) acutely. Patients had lower self-reported health compared to the background population (physical component scale (PCS); mean (standard deviation (SD)): 42.2 (11.1) vs. 47.1 (12.1), (p=0.0004), mental component scale (MCS); 50.1 (11.7) vs. 53.8 (9.2), (p=0.006), and more were sedentary (29 vs. 15%), (p=0.002). Large proportions had clinical signs of anxiety and depression, 25% and 22% respectively, exceeding a hospital anxiety and depression scale (HADS) cut-off score of 8. Almost half (47%) had not been offered cardiac rehabilitation (CR). CONCLUSIONS: After IE, mortality and readmission rates were high and self-reported physical and mental health poor. These findings call for changes in in-hospital and post-discharge management.
Authors: Johan S Bundgaard; Kasper Iversen; Mia Pries-Heje; Nikolaj Ihlemann; Sabine U Gill; Trine Madsen; Hanne Elming; Jonas A Povlsen; Niels E Bruun; Dan E Høfsten; Kurt Fuursted; Jens J Christensen; Martin Schultz; Flemming Rosenvinge; Jannik Helweg-Larsen; Lars Køber; Christian Torp-Pedersen; Emil L Fosbøl; Niels Tønder; Claus Moser; Henning Bundgaard; Ulrik M Mogensen Journal: Qual Life Res Date: 2022-03-29 Impact factor: 3.440
Authors: Anne Vinggaard Christensen; Jane K Dixon; Knud Juel; Ola Ekholm; Trine Bernholdt Rasmussen; Britt Borregaard; Rikke Elmose Mols; Lars Thrysøe; Charlotte Brun Thorup; Selina Kikkenborg Berg Journal: Health Qual Life Outcomes Date: 2020-01-07 Impact factor: 3.186