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

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

N1 - Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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 -