Trine Bernholdt Rasmussen1, Pernille Palm, Margrethe Herning, Anne Vinggaard Christensen, Britt Borregaard, Kathrine Sjøstedt Gandrup Nielsen, Lars Thrysoee, Charlotte Brun Thorup, Rikke Mols, Knud Juel, Ola Ekholm, Selina Kikkenborg Berg. 1. Trine Bernholdt Rasmussen, PhD Postdoc, Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark. Pernille Palm, PhD Clinical Nurse Specialist/Postdoc, The Heart Centre, Copenhagen University Hospital, Denmark. Margrethe Herning, MSU Clinical Nurse Specialist, Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark. Anne Vinggaard Christensen, MSPH PhD student, The Heart Centre, Copenhagen University Hospital, Denmark. Britt Borregaard, MPQM PhD student, Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Denmark. Kathrine Sjøstedt Gandrup Nielsen, BPH Research Assistant, Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark. Lars Thrysoee, PhD Clinical Nurse Researcher, Department of Cardiology, Odense University Hospital, Denmark; and University of Southern Denmark, Odense. Charlotte Brun Thorup, PhD Postdoc, Department of Cardiology and Department of Cardiothoracic Surgery and Clinical Nursing Research Unit, Aalborg University Hospital, Denmark. Rikke Mols, PhD Clinical Nurse Specialist/Postdoc, Department of Cardiology, Aarhus University Hospital, Denmark. Knud Juel, PhD Professor, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. Ola Ekholm, PhD Senior Researcher, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. Selina Kikkenborg Berg, PhD Professor, The Heart Centre, Copenhagen University Hospital, Denmark.
Abstract
BACKGROUND: A growing population is living with ischemic heart disease (IHD). Patient-reported outcomes (PROs) are reliable prognostic tools. Studies exploring PROs are needed to identify vulnerable patients and guide targeted healthcare strategies. OBJECTIVES: The aims of this study were to (i) describe PROs at hospital discharge across 3 diagnostic subgroups: (1) chronic IHD/stable angina, (2) non-ST-elevation myocardial infarction (non-STEMI)/unstable angina, and (3) ST-elevation myocardial infarction (STEMI), and (ii) examine determinants for PROs at hospital discharge in patients with IHD. METHODS: This study included a national cohort with register-data linkage including 14 115 adults with IHD discharged from Danish heart centers. Eligible patients (n = 13 476) were invited to complete a questionnaire, and 7 167 (53%) responded. Questionnaires included the Medical Outcome Study Short-Form 12, the Hospital Anxiety and Depression Scale, EuroQoL, HeartQoL, the Edmonton Symptom Assessment Scale, and ancillary questions. Sociodemographic and clinical characteristics were obtained from national registers. Student t test, χ test, and adjusted linear and logistic regression analyses were conducted to investigate subgroup differences, and adjusted linear and logistic regression analyses were conducted to explore determinants for PROs. RESULTS: Statistically significant subgroup differences were found, with groups reporting worst to best scores for most of PROs being as follows: chronic IHD/stable angina, non-STEMI/unstable angina, and STEMI. Symptoms of anxiety were highly prevalent in the non-STEMI/unstable angina group, with 33.8% exceeding a Hospital Anxiety and Depression Scale-Anxiety cutoff score indicating a possible anxiety disorder. Determinants for worse PROs included female sex, lower educational level, obesity, and poor physical fitness. CONCLUSIONS: Significant differences in PROs across IHD subgroups were observed and determinants for poor outcomes suggested. Results may guide differentiated care initiatives and resource allocation for preventative strategies.
BACKGROUND: A growing population is living with ischemic heart disease (IHD). Patient-reported outcomes (PROs) are reliable prognostic tools. Studies exploring PROs are needed to identify vulnerable patients and guide targeted healthcare strategies. OBJECTIVES: The aims of this study were to (i) describe PROs at hospital discharge across 3 diagnostic subgroups: (1) chronic IHD/stable angina, (2) non-ST-elevation myocardial infarction (non-STEMI)/unstable angina, and (3) ST-elevation myocardial infarction (STEMI), and (ii) examine determinants for PROs at hospital discharge in patients with IHD. METHODS: This study included a national cohort with register-data linkage including 14 115 adults with IHD discharged from Danish heart centers. Eligible patients (n = 13 476) were invited to complete a questionnaire, and 7 167 (53%) responded. Questionnaires included the Medical Outcome Study Short-Form 12, the Hospital Anxiety and Depression Scale, EuroQoL, HeartQoL, the Edmonton Symptom Assessment Scale, and ancillary questions. Sociodemographic and clinical characteristics were obtained from national registers. Student t test, χ test, and adjusted linear and logistic regression analyses were conducted to investigate subgroup differences, and adjusted linear and logistic regression analyses were conducted to explore determinants for PROs. RESULTS: Statistically significant subgroup differences were found, with groups reporting worst to best scores for most of PROs being as follows: chronic IHD/stable angina, non-STEMI/unstable angina, and STEMI. Symptoms of anxiety were highly prevalent in the non-STEMI/unstable angina group, with 33.8% exceeding a Hospital Anxiety and Depression Scale-Anxiety cutoff score indicating a possible anxiety disorder. Determinants for worse PROs included female sex, lower educational level, obesity, and poor physical fitness. CONCLUSIONS: Significant differences in PROs across IHD subgroups were observed and determinants for poor outcomes suggested. Results may guide differentiated care initiatives and resource allocation for preventative strategies.