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

Trine Bernholdt Rasmussen; Ann-Dorthe Zwisler; Lau Caspar Thygesen; Henning Bundgaard; Philip Moons; Selina Kikkenborg Berg

doi:10.1016/j.ijcard.2017.02.077

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

Trine Bernholdt Rasmussen, Ann-Dorthe Zwisler, Lau Caspar Thygesen, Henning Bundgaard, Philip Moons, Selina Kikkenborg Berg

Department of Clinical Medicine

10 Citations (Scopus)

Abstract

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.

Original language	English
Journal	International Journal of Cardiology
Volume	235
Pages (from-to)	133-140
ISSN	0167-5273
DOIs	https://doi.org/10.1016/j.ijcard.2017.02.077
Publication status	Published - 15 May 2017

Keywords

Adult
Cardiac Rehabilitation
Denmark
Endocarditis
Female
Hospitalization
Humans
Male
Mental Health
Middle Aged
Needs Assessment
Patient Readmission
Patient Reported Outcome Measures
Prognosis
Registries
Risk Assessment
Survival Analysis
Journal Article

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ijcard.2017.02.077

Cite this

High readmission rates and mental distress after infective endocarditis: Results from the national population-based CopenHeart IE survey. / Rasmussen, Trine Bernholdt; Zwisler, Ann-Dorthe; Thygesen, Lau Caspar et al.
In: International Journal of Cardiology, Vol. 235, 15.05.2017, p. 133-140.

Research output: Contribution to journal › Journal article › Research › peer-review

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

abstract = "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.",

keywords = "Adult, Cardiac Rehabilitation, Denmark, Endocarditis, Female, Hospitalization, Humans, Male, Mental Health, Middle Aged, Needs Assessment, Patient Readmission, Patient Reported Outcome Measures, Prognosis, Registries, Risk Assessment, Survival Analysis, Journal Article",

author = "Rasmussen, {Trine Bernholdt} and Ann-Dorthe Zwisler and Thygesen, {Lau Caspar} and Henning Bundgaard and Philip Moons and Berg, {Selina Kikkenborg}",

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month = may,

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doi = "10.1016/j.ijcard.2017.02.077",

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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

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.

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KW - Cardiac Rehabilitation

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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

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DO - 10.1016/j.ijcard.2017.02.077

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