TY - JOUR

T1 - Patient-reported outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses

T2 - Findings from the national DenHeart survey

AU - Berg, Selina K.

AU - Thorup, Charlotte B.

AU - Borregaard, Britt

AU - Christensen, Anne V.

AU - Thrysoee, Lars

AU - Rasmussen, Trine B.

AU - Ekholm, Ola

AU - Juel, Knud

AU - Vamosi, Marianne

PY - 2019/4

Y1 - 2019/4

N2 - 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.

AB - 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.

KW - cardiac events

KW - cardiology

KW - Health surveys

KW - mortality

KW - patient-centred outcomes research

KW - population registers

U2 - 10.1177/2047487318769766

DO - 10.1177/2047487318769766

M3 - Journal article

C2 - 29638142

AN - SCOPUS:85045245988

VL - 26

SP - 624

EP - 637

JO - European Journal of Preventive Cardiology

JF - European Journal of Preventive Cardiology

SN - 2047-4873

IS - 6

ER -