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Patient reported health status and all-cause mortality in patients with coronary heart disease
Adam J N Raymakers1,2, Paddy Gillespie1,2, Edel Murphy3
1CÚRAM SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.
Insights
Patient-rated physical and mental health status significantly impacts mortality risk in coronary heart disease patients. Higher scores in both physical and mental health were linked to a reduced likelihood of death over six years.
Area of Science:
- Cardiology
- Public Health
- Health Psychology
Background:
- Coronary heart disease (CHD) negatively affects patients' quality of life and may increase long-term mortality risk.
- Patient-reported health status is a crucial factor in managing chronic conditions.
Purpose of the Study:
- To investigate the association between patient-rated physical and mental health status and all-cause mortality at a 6-year follow-up.
- To analyze this association in patients with CHD receiving primary care in Ireland and Northern Ireland.
Main Methods:
- Secondary data analysis of 762 patients with CHD from a 2004-2010 cluster randomized controlled trial.
- Utilized the 12-Item Short-Form Health Survey (SF-12) to assess physical component summary (PCS) and mental component summary (MCS) scores.
- Employed multivariate regression using generalized estimating equations (GEE) to determine associations with all-cause mortality.
Main Results:
- Higher baseline mental component summary (MCS) scores were associated with a reduced risk of mortality (adjusted OR: 0.97, 95% CI: 0.95-0.99).
- Higher baseline physical component summary (PCS) scores were also associated with a reduced risk of mortality (adjusted OR: 0.97, 95% CI: 0.95-0.99).
- A five-point increase in either MCS or PCS scores correlated with a 14% decrease in the likelihood of all-cause mortality.
Conclusions:
- Both patient-rated mental and physical health status are significant predictors of mortality in CHD patients.
- The impact of mental and physical health status on mortality risk was comparable in magnitude.
- Improving patient-reported health outcomes may be a viable strategy to reduce mortality in coronary heart disease populations.
Purpose:
Patients with coronary heart disease (CHD) experience reduced quality of life which may be associated with mortality in the longer term. This study explores whether patient-rated physical and mental health status was associated with mortality at 6-year follow-up among patients with CHD attending primary care in Ireland and Northern Ireland.
Methods:
This study is a secondary data analysis of patients with CHD recruited to a cluster randomized controlled trial from 2004 to 2010. Data collected included patient-rated physical component summary (PCS) and mental component summary (MCS) scores of health status (from the 12-Item Short-Form Health Survey (SF-12)), demographics and clinical parameters at baseline, and all-cause mortality at 6-year follow-up. Multivariate regression was conducted using generalized estimating equations (GEE) with a log-link function. Results are presented as odds ratios (ORs) and 95% confidence intervals (CIs).
Results:
The study consisted of 762 individuals with mean age 67.6 years [standard deviation (SD): 9.8], and was 29% female. Mean baseline SF-12 mental (MCS) and physical (PCS) component scores were 50.0 (SD: 10.8) and 39.6 (SD: 11.2), respectively. At 6-year follow-up, the adjusted OR for the baseline MCS for mortality was 0.97 (95% CI: 0.95-0.99) and for the PCS 0.97 (95% CI: 0.95-0.99). For every five-point increase in MCS and PCS scores, there was a 14% reduction in the likelihood of all-cause mortality.
Conclusions:
Overall, the magnitude of effect for both mental health status and physical health status was similar; higher scores were significantly associated with a lower risk of mortality at 6-year follow-up.
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