High readmission rate after heart valve surgery: A nationwide cohort study

K L Sibilitz; S K Berg; Lau Caspar Thygesen; T B Hansen; L Køber; C Hassager; A-D Zwisler

doi:10.1016/j.ijcard.2015.04.078

High readmission rate after heart valve surgery: A nationwide cohort study

K L Sibilitz, S K Berg, Lau Caspar Thygesen, T B Hansen, L Køber, C Hassager, A-D Zwisler

38 Citationer (Scopus)

Abstract

Background: After heart valve surgery, knowledge on long-term self-reported health status and readmission is lacking. Thus, the optimal strategy for out-patient management after surgery remains unclear. Methods: Using a nationwide survey with linkage to Danish registers with one year follow-up, we included all adults 6-12 months after heart valve surgery irrespective of valve procedure, during Jan-June 2011 (n = 867). Participants completed a questionnaire regarding health-status (n = 742), and answers were compared with age- and sex-matched healthy controls. Readmission rates and mortality were investigated. Results: After valve surgery, the self-reported health was lower (Short Form-36 (SF-36) Physical Component Scale (PCS): 44.5 vs. 50.6 and Mental Component Scale (MCS): 51.9 vs. 55.0, p < 0.0001) and more were physically sedentary compared with healthy controls (11.1% vs. 15.2%). Clinical signs of anxiety and depression were present in 13.6% and 13.8%, respectively (Hospital Anxiety and Depression Scale score ≥ 8). Twelve months following discharge, 483 persons (56%) were readmitted. Readmission was associated with lower self-reported health (SF-36 PCS: 46.5 vs. 43.9, and MCS 52.2 vs. 50.7). Higher age (hazard ratio (95% CI): 1.3 (1.0-1.6)), male sex (1.2 (1.0-1.5)), mitral valve surgery (1.3 (1.0-1.6)), and infective endocarditis after surgery (1.8 (1.1-3.0), p: 0.01) predicted readmission, whereas higher age (2.3 (1.0-5.4)), higher comorbidity score (3.2 (1.8-6.0)), and infective endocarditis after surgery (3.2 (1.2-8.9)) predicted mortality. Conclusions: 6-12 months after heart valve surgery the readmission rate is high and the self-reported health status is low. Readmission is associated with low self-reported health. Therefore, targeted follow-up strategies post-surgery are needed.

Originalsprog	Engelsk
Tidsskrift	International Journal of Cardiology
Vol/bind	189
Sider (fra-til)	96-104
Antal sider	9
ISSN	0167-5273
DOI	https://doi.org/10.1016/j.ijcard.2015.04.078
Status	Udgivet - 1 aug. 2015

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10.1016/j.ijcard.2015.04.078

Citationsformater

@article{2c29e63ba9a04eaa8d56b048a9d942b4,

title = "High readmission rate after heart valve surgery: A nationwide cohort study",

abstract = "Background: After heart valve surgery, knowledge on long-term self-reported health status and readmission is lacking. Thus, the optimal strategy for out-patient management after surgery remains unclear. Methods: Using a nationwide survey with linkage to Danish registers with one year follow-up, we included all adults 6-12 months after heart valve surgery irrespective of valve procedure, during Jan-June 2011 (n = 867). Participants completed a questionnaire regarding health-status (n = 742), and answers were compared with age- and sex-matched healthy controls. Readmission rates and mortality were investigated. Results: After valve surgery, the self-reported health was lower (Short Form-36 (SF-36) Physical Component Scale (PCS): 44.5 vs. 50.6 and Mental Component Scale (MCS): 51.9 vs. 55.0, p < 0.0001) and more were physically sedentary compared with healthy controls (11.1% vs. 15.2%). Clinical signs of anxiety and depression were present in 13.6% and 13.8%, respectively (Hospital Anxiety and Depression Scale score ≥ 8). Twelve months following discharge, 483 persons (56%) were readmitted. Readmission was associated with lower self-reported health (SF-36 PCS: 46.5 vs. 43.9, and MCS 52.2 vs. 50.7). Higher age (hazard ratio (95% CI): 1.3 (1.0-1.6)), male sex (1.2 (1.0-1.5)), mitral valve surgery (1.3 (1.0-1.6)), and infective endocarditis after surgery (1.8 (1.1-3.0), p: 0.01) predicted readmission, whereas higher age (2.3 (1.0-5.4)), higher comorbidity score (3.2 (1.8-6.0)), and infective endocarditis after surgery (3.2 (1.2-8.9)) predicted mortality. Conclusions: 6-12 months after heart valve surgery the readmission rate is high and the self-reported health status is low. Readmission is associated with low self-reported health. Therefore, targeted follow-up strategies post-surgery are needed.",

keywords = "Adolescent, Adult, Aged, Cohort Studies, Cross-Sectional Studies, Denmark, Female, Follow-Up Studies, Heart Valve Diseases, Heart Valve Prosthesis Implantation, Hospital Mortality, Humans, Incidence, Length of Stay, Male, Middle Aged, Multivariate Analysis, Patient Readmission, Postoperative Complications, Predictive Value of Tests, Proportional Hazards Models, Registries, Risk Assessment, Self Report, Sickness Impact Profile, Survival Analysis, Young Adult",

author = "Sibilitz, {K L} and Berg, {S K} and Thygesen, {Lau Caspar} and Hansen, {T B} and L K{\o}ber and C Hassager and A-D Zwisler",

year = "2015",

month = aug,

day = "1",

doi = "10.1016/j.ijcard.2015.04.078",

language = "English",

volume = "189",

pages = "96--104",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - High readmission rate after heart valve surgery

T2 - A nationwide cohort study

AU - Sibilitz, K L

AU - Berg, S K

AU - Thygesen, Lau Caspar

AU - Hansen, T B

AU - Køber, L

AU - Hassager, C

AU - Zwisler, A-D

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Background: After heart valve surgery, knowledge on long-term self-reported health status and readmission is lacking. Thus, the optimal strategy for out-patient management after surgery remains unclear. Methods: Using a nationwide survey with linkage to Danish registers with one year follow-up, we included all adults 6-12 months after heart valve surgery irrespective of valve procedure, during Jan-June 2011 (n = 867). Participants completed a questionnaire regarding health-status (n = 742), and answers were compared with age- and sex-matched healthy controls. Readmission rates and mortality were investigated. Results: After valve surgery, the self-reported health was lower (Short Form-36 (SF-36) Physical Component Scale (PCS): 44.5 vs. 50.6 and Mental Component Scale (MCS): 51.9 vs. 55.0, p < 0.0001) and more were physically sedentary compared with healthy controls (11.1% vs. 15.2%). Clinical signs of anxiety and depression were present in 13.6% and 13.8%, respectively (Hospital Anxiety and Depression Scale score ≥ 8). Twelve months following discharge, 483 persons (56%) were readmitted. Readmission was associated with lower self-reported health (SF-36 PCS: 46.5 vs. 43.9, and MCS 52.2 vs. 50.7). Higher age (hazard ratio (95% CI): 1.3 (1.0-1.6)), male sex (1.2 (1.0-1.5)), mitral valve surgery (1.3 (1.0-1.6)), and infective endocarditis after surgery (1.8 (1.1-3.0), p: 0.01) predicted readmission, whereas higher age (2.3 (1.0-5.4)), higher comorbidity score (3.2 (1.8-6.0)), and infective endocarditis after surgery (3.2 (1.2-8.9)) predicted mortality. Conclusions: 6-12 months after heart valve surgery the readmission rate is high and the self-reported health status is low. Readmission is associated with low self-reported health. Therefore, targeted follow-up strategies post-surgery are needed.

AB - Background: After heart valve surgery, knowledge on long-term self-reported health status and readmission is lacking. Thus, the optimal strategy for out-patient management after surgery remains unclear. Methods: Using a nationwide survey with linkage to Danish registers with one year follow-up, we included all adults 6-12 months after heart valve surgery irrespective of valve procedure, during Jan-June 2011 (n = 867). Participants completed a questionnaire regarding health-status (n = 742), and answers were compared with age- and sex-matched healthy controls. Readmission rates and mortality were investigated. Results: After valve surgery, the self-reported health was lower (Short Form-36 (SF-36) Physical Component Scale (PCS): 44.5 vs. 50.6 and Mental Component Scale (MCS): 51.9 vs. 55.0, p < 0.0001) and more were physically sedentary compared with healthy controls (11.1% vs. 15.2%). Clinical signs of anxiety and depression were present in 13.6% and 13.8%, respectively (Hospital Anxiety and Depression Scale score ≥ 8). Twelve months following discharge, 483 persons (56%) were readmitted. Readmission was associated with lower self-reported health (SF-36 PCS: 46.5 vs. 43.9, and MCS 52.2 vs. 50.7). Higher age (hazard ratio (95% CI): 1.3 (1.0-1.6)), male sex (1.2 (1.0-1.5)), mitral valve surgery (1.3 (1.0-1.6)), and infective endocarditis after surgery (1.8 (1.1-3.0), p: 0.01) predicted readmission, whereas higher age (2.3 (1.0-5.4)), higher comorbidity score (3.2 (1.8-6.0)), and infective endocarditis after surgery (3.2 (1.2-8.9)) predicted mortality. Conclusions: 6-12 months after heart valve surgery the readmission rate is high and the self-reported health status is low. Readmission is associated with low self-reported health. Therefore, targeted follow-up strategies post-surgery are needed.

KW - Adolescent

KW - Adult

KW - Aged

KW - Cohort Studies

KW - Cross-Sectional Studies

KW - Denmark

KW - Female

KW - Follow-Up Studies

KW - Heart Valve Diseases

KW - Heart Valve Prosthesis Implantation

KW - Hospital Mortality

KW - Humans

KW - Incidence

KW - Length of Stay

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Patient Readmission

KW - Postoperative Complications

KW - Predictive Value of Tests

KW - Proportional Hazards Models

KW - Registries

KW - Risk Assessment

KW - Self Report

KW - Sickness Impact Profile

KW - Survival Analysis

KW - Young Adult

U2 - 10.1016/j.ijcard.2015.04.078

DO - 10.1016/j.ijcard.2015.04.078

M3 - Journal article

C2 - 25889437

SN - 0167-5273

VL - 189

SP - 96

EP - 104

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

High readmission rate after heart valve surgery: A nationwide cohort study

Abstract

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