High readmission rates and mental distress after infective endocarditis: Results from the national population-based CopenHeart IE survey

TY - JOUR

T1 - High readmission rates and mental distress after infective endocarditis

T2 - Results from the national population-based CopenHeart IE survey

AU - Rasmussen, Trine Bernholdt

AU - Zwisler, Ann-Dorthe

AU - Thygesen, Lau Caspar

AU - Bundgaard, Henning

AU - Moons, Philip

AU - Berg, Selina Kikkenborg

N1 - Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

PY - 2017/5/15

Y1 - 2017/5/15

N2 - BACKGROUND: Infective endocarditis (IE) is a severe disease requiring lengthy hospitalisation. Little is known about patients' recovery after IE. The aims of this study in IE patients were; (i) to describe mortality, readmission, self-reported health and rehabilitation up to 1year post-discharge, (ii) to examine associations between self-reported health and readmission, and (iii) to investigate predictors of readmission and mortality.METHODS: All adults treated for IE in Denmark, January-June 2011 (N=347), were followed in registers. Eligible individuals (n=209) were invited to participate in a questionnaire survey (responders n=122). Responses were compared with those of a background reference population and a heart valve surgery population. Mortality and readmission data from registers 12months post-discharge were investigated.RESULTS: Patients discharged after treatment for IE had a mortality of 18% (95% confidence interval (CI): 14%-23%) one year post-discharge and 65% (95% CI: 59%-71%) had been readmitted, the majority (82%) acutely. Patients had lower self-reported health compared to the background population (physical component scale (PCS); mean (standard deviation (SD)): 42.2 (11.1) vs. 47.1 (12.1), (p=0.0004), mental component scale (MCS); 50.1 (11.7) vs. 53.8 (9.2), (p=0.006), and more were sedentary (29 vs. 15%), (p=0.002). Large proportions had clinical signs of anxiety and depression, 25% and 22% respectively, exceeding a hospital anxiety and depression scale (HADS) cut-off score of 8. Almost half (47%) had not been offered cardiac rehabilitation (CR).CONCLUSIONS: After IE, mortality and readmission rates were high and self-reported physical and mental health poor. These findings call for changes in in-hospital and post-discharge management.

AB - BACKGROUND: Infective endocarditis (IE) is a severe disease requiring lengthy hospitalisation. Little is known about patients' recovery after IE. The aims of this study in IE patients were; (i) to describe mortality, readmission, self-reported health and rehabilitation up to 1year post-discharge, (ii) to examine associations between self-reported health and readmission, and (iii) to investigate predictors of readmission and mortality.METHODS: All adults treated for IE in Denmark, January-June 2011 (N=347), were followed in registers. Eligible individuals (n=209) were invited to participate in a questionnaire survey (responders n=122). Responses were compared with those of a background reference population and a heart valve surgery population. Mortality and readmission data from registers 12months post-discharge were investigated.RESULTS: Patients discharged after treatment for IE had a mortality of 18% (95% confidence interval (CI): 14%-23%) one year post-discharge and 65% (95% CI: 59%-71%) had been readmitted, the majority (82%) acutely. Patients had lower self-reported health compared to the background population (physical component scale (PCS); mean (standard deviation (SD)): 42.2 (11.1) vs. 47.1 (12.1), (p=0.0004), mental component scale (MCS); 50.1 (11.7) vs. 53.8 (9.2), (p=0.006), and more were sedentary (29 vs. 15%), (p=0.002). Large proportions had clinical signs of anxiety and depression, 25% and 22% respectively, exceeding a hospital anxiety and depression scale (HADS) cut-off score of 8. Almost half (47%) had not been offered cardiac rehabilitation (CR).CONCLUSIONS: After IE, mortality and readmission rates were high and self-reported physical and mental health poor. These findings call for changes in in-hospital and post-discharge management.

KW - Adult

KW - Cardiac Rehabilitation

KW - Denmark

KW - Endocarditis

KW - Female

KW - Hospitalization

KW - Humans

KW - Male

KW - Mental Health

KW - Middle Aged

KW - Needs Assessment

KW - Patient Readmission

KW - Patient Reported Outcome Measures

KW - Prognosis

KW - Registries

KW - Risk Assessment

KW - Survival Analysis

KW - Journal Article

U2 - 10.1016/j.ijcard.2017.02.077

DO - 10.1016/j.ijcard.2017.02.077

M3 - Journal article

C2 - 28262341

SN - 0167-5273

VL - 235

SP - 133

EP - 140

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -