DenHeart: Differences in physical and mental health across cardiac diagnoses at hospital discharge

TY - JOUR

T1 - DenHeart

T2 - Differences in physical and mental health across cardiac diagnoses at hospital discharge

AU - Berg, Selina Kikkenborg

AU - Rasmussen, Trine Bernholdt

AU - Thrysoee, Lars

AU - Lauberg, Astrid

AU - Borregaard, Britt

AU - Christensen, Anne Vinggaard

AU - Ekholm, Ola

AU - Juel, Knud

AU - Svanholm, Jette Rolf

PY - 2017/3

Y1 - 2017/3

N2 - Objective To describe: (i) differences in patient reported physical and mental health outcomes at hospital discharge between a) cardiac diagnostic groups and b) cardiac patients and a national representative reference population and to describe (ii) in-hospital predicting factors for patient reported outcomes. Methods A national cross-sectional survey combined with national register data. From April 2013 to April 2014 all patients (n = 34,564) discharged or transferred from one of five Danish Heart Centres were invited to participate. 16,712 patients (51%) responded; 67% male and mean age 64 years. All diagnostic groups were represented similar to real life proportions. Patient reported outcome measures included: SF-12, Hospital Anxiety and Depression Scale, EQ-5D, Brief Illness Perception Questionnaire, HeartQoL and Edmonton Symptom Assessment Scale. Results Statistically significant differences were found in all patient reported outcomes across diagnostic groups. Listed from worst to best outcomes were heart failure, heart valve disease, ischemic heart disease, infectious heart disease, arrhythmia, congenital heart disease and heart transplant. Also “observation for cardiac disease” scored poorly on some aspects such as anxiety and treatment control. Compared to the reference population, cardiac patients had lower physical and mental health scores. Predicting factors for worse outcomes across diagnoses were female sex, older age, being unmarried, planned admission, longer hospital stay, and higher co-morbidity score. Conclusions This large nationwide study finds significant differences in patient reported outcomes across cardiac diagnostic groups, however the differences were small and did not reach minimal important difference. The total population of cardiac patients had significant and clinically relevant poorer scores on mental and physical health than the reference population. Predicting factors for poor outcomes were identified. It is the first study comparing all diagnostic groups within cardiology and it provides important benchmarks between diagnostic groups and future comparisons. This knowledge may help clinicians make better decisions about post-hospital care and prevention.

AB - Objective To describe: (i) differences in patient reported physical and mental health outcomes at hospital discharge between a) cardiac diagnostic groups and b) cardiac patients and a national representative reference population and to describe (ii) in-hospital predicting factors for patient reported outcomes. Methods A national cross-sectional survey combined with national register data. From April 2013 to April 2014 all patients (n = 34,564) discharged or transferred from one of five Danish Heart Centres were invited to participate. 16,712 patients (51%) responded; 67% male and mean age 64 years. All diagnostic groups were represented similar to real life proportions. Patient reported outcome measures included: SF-12, Hospital Anxiety and Depression Scale, EQ-5D, Brief Illness Perception Questionnaire, HeartQoL and Edmonton Symptom Assessment Scale. Results Statistically significant differences were found in all patient reported outcomes across diagnostic groups. Listed from worst to best outcomes were heart failure, heart valve disease, ischemic heart disease, infectious heart disease, arrhythmia, congenital heart disease and heart transplant. Also “observation for cardiac disease” scored poorly on some aspects such as anxiety and treatment control. Compared to the reference population, cardiac patients had lower physical and mental health scores. Predicting factors for worse outcomes across diagnoses were female sex, older age, being unmarried, planned admission, longer hospital stay, and higher co-morbidity score. Conclusions This large nationwide study finds significant differences in patient reported outcomes across cardiac diagnostic groups, however the differences were small and did not reach minimal important difference. The total population of cardiac patients had significant and clinically relevant poorer scores on mental and physical health than the reference population. Predicting factors for poor outcomes were identified. It is the first study comparing all diagnostic groups within cardiology and it provides important benchmarks between diagnostic groups and future comparisons. This knowledge may help clinicians make better decisions about post-hospital care and prevention.

KW - Cardiology

KW - Patient-centered outcomes research

KW - Quality of life

KW - Registries

U2 - 10.1016/j.jpsychores.2017.01.003

DO - 10.1016/j.jpsychores.2017.01.003

M3 - Journal article

C2 - 28183396

AN - SCOPUS:85009084228

SN - 0022-3999

VL - 94

SP - 1

EP - 9

JO - Journal of Psychosomatic Research

JF - Journal of Psychosomatic Research

ER -