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Patient-reported outcomes, sociodemographic and clinical factors are associated with 1-year mortality in patients with ischemic heart disease—findings from the DenHeart cohort study

  • 22-07-2021
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Abstract

Purpose

In patients with ischemic heart disease, the objectives were (1) to explore associations between patient-reported outcomes, sociodemographic, and clinical factors at discharge and 1-year all-cause mortality and (2) to investigate the discriminant predictive performance of the applied patient-reported outcome instruments on 1-year all-cause mortality.

Methods

Data from the Danish national DenHeart cohort study were used. Eligible patients (n = 13,476) were invited to complete a questionnaire-package, of which 7167 (53%) responded. Questionnaires included the 12-item Short form health survey (SF-12), Hospital anxiety and depression scale (HADS), EQ-5D, HeartQoL, Edmonton symptom assessment scale (ESAS), and ancillary questions on, e.g., social support. Clinical and demographic characteristics were obtained from registers, as were data on mortality. Comparative analyses were used to investigate differences in patient-reported outcomes. Mortality associations were explored using multifactorially adjusted Cox regression analyses. Predictive performance was analyzed using receiver operating characteristics (ROC).

Results

Patient-reported outcomes at discharge differed among those alive versus those deceased at one year, e.g., depression (HADS-Depression ≥ 8) 19% vs. 44% (p < 0.001). Associations with 1-year mortality included feeling unsafe about returning home from the hospital; hazard ratio (HR) 2.07 (95% CI 1.2–3.61); high comorbidity level, HR 3.6 (95% CI 2.7–4.8); and being unmarried, HR 1.60 (95% CI 1.33–1.93). Best predictive performance was observed for SF-12 physical component summary (Area under the curve (AUC) 0.706).

Conclusion

Patient-reported health, sociodemographic, and clinical factors are associated with 1-year mortality. We propose systematic screening with robust predictive tools to identify patients at risk and healthcare initiatives to explore and offer effective treatment to modify patient-reported health indicators.
Titel
Patient-reported outcomes, sociodemographic and clinical factors are associated with 1-year mortality in patients with ischemic heart disease—findings from the DenHeart cohort study
Auteurs
Trine Bernholdt Rasmussen
Britt Borregaard
Pernille Palm
Rikke Elmose Mols
Anne Vinggaard Christensen
Knud Juel
Ola Ekholm
Charlotte Brun Thorup
Lars Thrysoee
Marie Gjengedal
Selina Kikkenborg Berg
Publicatiedatum
22-07-2021
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 2/2022
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-021-02956-5
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Deze inhoud is alleen zichtbaar als je bent ingelogd en de juiste rechten hebt.