Patient-reported outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses: Findings from the national DenHeart survey. (April 2019)

• Record Type: Journal Article
• Authors: Berg, Selina K; Thorup, Charlotte B; Borregaard, Britt; Christensen, Anne V; Thrysoee, Lars; Rasmussen, Trine B; Ekholm, Ola; Juel, Knud; Vamosi, Marianne
• Is Part Of: European journal of preventive cardiology. Volume 26:Number 6(2019)
• Page Start: 624
• Page End: 637
• Publication Date: 2019-04
• Subjects: Health surveys -- cardiology -- patient-centred outcomes research -- population registers -- mortality -- cardiac events; Cardiovascular system -- Diseases -- Prevention -- Periodicals; Cardiac patients -- Rehabilitation -- Periodicals; 616.12
• DOI: 10.1177/2047487318769766
• Languages: English
• ISSNs: 2047-4873

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.