Selina K Berg1,2, Charlotte B Thorup3, Britt Borregaard4, Anne V Christensen1, Lars Thrysoee5, Trine B Rasmussen6, Ola Ekholm2, Knud Juel2, Marianne Vamosi7. 1. 1 Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Denmark. 2. 2 National Institute of Public Health, University of Southern Denmark, Denmark. 3. 3 Department of Cardiology and Department of Cardiothoracic Surgery and Clinical Nursing Research Unit, Aalborg University Hospital, Denmark. 4. 4 Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Denmark. 5. 5 Department of Cardiology, Odense University Hospital, Denmark. 6. 6 Department of Cardiology, Gentofte University Hospital, Denmark. 7. 7 Aarhus University, Institute of Public Health, Section of Nursing Science. Department of Cardiology, Aarhus University Hospital, Denmark.
Abstract
AIMS: Patient-reported quality of life and anxiety/depression scores provide important prognostic information independently of traditional clinical data. The aims of this study were to describe: (a) mortality and cardiac events one year after hospital discharge across cardiac diagnoses; (b) patient-reported outcomes at hospital discharge as a predictor of mortality and cardiac events. DESIGN: A cross-sectional survey with register follow-up. METHODS: Participants: All patients discharged from April 2013 to April 2014 from five national heart centres in Denmark. MAIN OUTCOMES: Patient-reported outcomes: anxiety and depression (Hospital Anxiety and Depression Scale); perceived health (Short Form-12); quality of life (HeartQoL and EQ-5D); symptom burden (Edmonton Symptom Assessment Scale). Register data: mortality and cardiac events within one year following discharge. RESULTS: There were 471 deaths among the 16,689 respondents in the first year after discharge. Across diagnostic groups, patients reporting symptoms of anxiety had a two-fold greater mortality risk when adjusted for age, sex, marital status, educational level, comorbidity, smoking, body mass index and alcohol intake (hazard ratio (HR) 1.92, 95% confidence interval (CI) 1.52-2.42). Similar increased mortality risks were found for patients reporting symptoms of depression (HR 2.29, 95% CI 1.81-2.90), poor quality of life (HR 0.46, 95% CI 0.39-0.54) and severe symptom distress (HR 2.47, 95% CI 1.92-3.19). Cardiac events were predicted by poor quality of life (HR 0.71, 95% CI 0.65-0.77) and severe symptom distress (HR 1.58, 95% CI 1.35-1.85). CONCLUSIONS: Patient-reported mental and physical health outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses.
AIMS: Patient-reported quality of life and anxiety/depression scores provide important prognostic information independently of traditional clinical data. The aims of this study were to describe: (a) mortality and cardiac events one year after hospital discharge across cardiac diagnoses; (b) patient-reported outcomes at hospital discharge as a predictor of mortality and cardiac events. DESIGN: A cross-sectional survey with register follow-up. METHODS:Participants: All patients discharged from April 2013 to April 2014 from five national heart centres in Denmark. MAIN OUTCOMES: Patient-reported outcomes: anxiety and depression (Hospital Anxiety and Depression Scale); perceived health (Short Form-12); quality of life (HeartQoL and EQ-5D); symptom burden (Edmonton Symptom Assessment Scale). Register data: mortality and cardiac events within one year following discharge. RESULTS: There were 471 deaths among the 16,689 respondents in the first year after discharge. Across diagnostic groups, patients reporting symptoms of anxiety had a two-fold greater mortality risk when adjusted for age, sex, marital status, educational level, comorbidity, smoking, body mass index and alcohol intake (hazard ratio (HR) 1.92, 95% confidence interval (CI) 1.52-2.42). Similar increased mortality risks were found for patients reporting symptoms of depression (HR 2.29, 95% CI 1.81-2.90), poor quality of life (HR 0.46, 95% CI 0.39-0.54) and severe symptom distress (HR 2.47, 95% CI 1.92-3.19). Cardiac events were predicted by poor quality of life (HR 0.71, 95% CI 0.65-0.77) and severe symptom distress (HR 1.58, 95% CI 1.35-1.85). CONCLUSIONS:Patient-reported mental and physical health outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses.
Entities:
Keywords:
Health surveys; cardiac events; cardiology; mortality; patient-centred outcomes research; population registers
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