Marianne Vámosi1, Astrid Lauberg2, Britt Borregaard3, Anne Vinggaard Christensen4, Lars Thrysoee5, Trine Bernholdt Rasmussen6, Ola Ekholm7, Knud Juel8, Selina Kikkenborg Berg9. 1. Department of Public Health, Section for Nursing, Aarhus University, Aarhus C, Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Blv. 99, 8200, Aarhus N, Denmark. Electronic address: mvamosi@ph.au.dk. 2. Department of Cardiology and Cardiothoracic Surgery, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark. Electronic address: a.lauberg@rn.dk. 3. Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark. Electronic address: Britt.Borregaard@rsyd.dk. 4. Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark. Electronic address: anne.vinggaard.christensen@regionh.dk. 5. Department of Cardiology, Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, 5000, Odense, Denmark. Electronic address: lars.thrysoee@rsyd.dk. 6. Department of Cardiology, Herlev and Gentofte University Hospital, Kildegaardsvej 29, 2900, Hellerup, Denmark. Electronic address: Trine.Bernholdt.Rasmussen@regionh.dk. 7. National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark. Electronic address: oek@si-folkesundhed.dk. 8. National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark. Electronic address: kj@si-folkesundhed.dk. 9. Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark & Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, København N, Denmark. Electronic address: selina@rh.dk.
Abstract
BACKGROUND: High rates of readmission after myocardial infarction and cardiac surgery have been reported, indicating a heavy burden for both patients and society. Patient-reported outcomes are predictors of adverse outcomes such as morbidity and mortality and may also be useful in preventive risk assessment as predictors of readmission. AIM: To describe (i) the prevalence of cardiac readmissions one year after hospital discharge among cardiac patients, (ii) patient-reported outcomes at hospital discharge as predictors of readmission. METHODS: The following patient-reported outcomes were measured across cardiac diagnoses at hospital discharge from the five heart centres, cardiology and thoracic surgery units, as a part of the national, cross-sectional DenHeart Study: Short-Form 12 (SF-12), Hospital Anxiety and Depression Scale (HADS), EuroQoL (EQ-5D-5L), HeartQoL and the Edmonton Symptom Assessment Scale (ESAS). One year readmissions were obtained from national registers. RESULTS: A total of 34,564 cardiac patients were discharged of whom 16,712 patients completed the questionnaire. A total of 11,693 (36%) patients were readmitted for cardiac reasons at least once during the first year after index admission. The risk of readmission was predicted by anxiety (HR = 1.36 (CI:1.26-1.46)) and depression (HR = 1.42 (CI:1.31-1.55)). Higher scores reflected lower readmission risk on the physical (HR = 0.98 (CI:0.98-0.98)) health component of the SF-12. CONCLUSION: A total of 36% of cardiac patients admitted to a national heart center were readmitted during the first year. Readmission was predicted by patient-reported anxiety, depression, perceived health, quality of life and symptom distress, which may be used in risk assessment in clinical practice.
BACKGROUND: High rates of readmission after myocardial infarction and cardiac surgery have been reported, indicating a heavy burden for both patients and society. Patient-reported outcomes are predictors of adverse outcomes such as morbidity and mortality and may also be useful in preventive risk assessment as predictors of readmission. AIM: To describe (i) the prevalence of cardiac readmissions one year after hospital discharge among cardiac patients, (ii) patient-reported outcomes at hospital discharge as predictors of readmission. METHODS: The following patient-reported outcomes were measured across cardiac diagnoses at hospital discharge from the five heart centres, cardiology and thoracic surgery units, as a part of the national, cross-sectional DenHeart Study: Short-Form 12 (SF-12), Hospital Anxiety and Depression Scale (HADS), EuroQoL (EQ-5D-5L), HeartQoL and the Edmonton Symptom Assessment Scale (ESAS). One year readmissions were obtained from national registers. RESULTS: A total of 34,564 cardiac patients were discharged of whom 16,712 patients completed the questionnaire. A total of 11,693 (36%) patients were readmitted for cardiac reasons at least once during the first year after index admission. The risk of readmission was predicted by anxiety (HR = 1.36 (CI:1.26-1.46)) and depression (HR = 1.42 (CI:1.31-1.55)). Higher scores reflected lower readmission risk on the physical (HR = 0.98 (CI:0.98-0.98)) health component of the SF-12. CONCLUSION: A total of 36% of cardiac patients admitted to a national heart center were readmitted during the first year. Readmission was predicted by patient-reported anxiety, depression, perceived health, quality of life and symptom distress, which may be used in risk assessment in clinical practice.
Authors: Cheng-Fu Lin; Yu-Hui Huang; Li-Ying Ju; Shuo-Chun Weng; Yu-Shan Lee; Yin-Yi Chou; Chu-Sheng Lin; Shih-Yi Lin Journal: Int J Environ Res Public Health Date: 2020-07-24 Impact factor: 3.390