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Patient-reported outcomes predict high readmission rates among patients with cardiac diagnoses. Findings from the
Marianne Vámosi1, Astrid Lauberg2, Britt Borregaard3
1Department of Public Health, Section for Nursing, Aarhus University, Aarhus C, Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Blv. 99, 8200, Aarhus N, Denmark.
Insights
High rates of cardiac readmissions occur within a year of discharge. Patient-reported anxiety and depression significantly predict these readmissions, offering potential for improved risk assessment and patient care strategies.
Area of Science:
- Cardiology
- Health Services Research
- Patient Outcomes
Background:
- High rates of hospital readmission following myocardial infarction and cardiac surgery pose a significant burden on patients and healthcare systems.
- Patient-reported outcomes (PROs) are emerging as crucial predictors of adverse events, including morbidity, mortality, and hospital readmissions.
Purpose of the Study:
- To determine the prevalence of cardiac readmissions within one year post-discharge.
- To identify patient-reported outcomes at hospital discharge that predict these readmissions.
Main Methods:
- A national, cross-sectional study (DenHeart Study) involving cardiac patients from five heart centers.
- Patient-reported outcomes were assessed using validated instruments (SF-12, HADS, EQ-5D-5L, HeartQoL, ESAS) at discharge.
- One-year readmission data were obtained from national health registers.
Main Results:
- Out of 34,564 discharged patients, 16,712 completed questionnaires; 36% experienced at least one cardiac readmission within the first year.
- Anxiety (HR=1.36) and depression (HR=1.42) were significant predictors of readmission.
- Higher scores on the physical health component of the SF-12 were associated with a lower risk of readmission (HR=0.98).
Conclusions:
- Thirty-six percent of cardiac patients were readmitted within the first year, highlighting a substantial clinical challenge.
- Patient-reported anxiety, depression, perceived health, quality of life, and symptom distress are key predictors of readmission.
- These patient-reported outcomes can be integrated into clinical practice for enhanced risk stratification and preventive strategies.
Background:
High rates of readmission after myocardial infarction and cardiac surgery have been reported, indicating a heavy burden for both patients and society. Patient-reported outcomes are predictors of adverse outcomes such as morbidity and mortality and may also be useful in preventive risk assessment as predictors of readmission.
Aim:
To describe (i) the prevalence of cardiac readmissions one year after hospital discharge among cardiac patients, (ii) patient-reported outcomes at hospital discharge as predictors of readmission.
Methods:
The following patient-reported outcomes were measured across cardiac diagnoses at hospital discharge from the five heart centres, cardiology and thoracic surgery units, as a part of the national, cross-sectional DenHeart Study: Short-Form 12 (SF-12), Hospital Anxiety and Depression Scale (HADS), EuroQoL (EQ-5D-5L), HeartQoL and the Edmonton Symptom Assessment Scale (ESAS). One year readmissions were obtained from national registers.
Results:
A total of 34,564 cardiac patients were discharged of whom 16,712 patients completed the questionnaire. A total of 11,693 (36%) patients were readmitted for cardiac reasons at least once during the first year after index admission. The risk of readmission was predicted by anxiety (HR = 1.36 (CI:1.26-1.46)) and depression (HR = 1.42 (CI:1.31-1.55)). Higher scores reflected lower readmission risk on the physical (HR = 0.98 (CI:0.98-0.98)) health component of the SF-12.
Conclusion:
A total of 36% of cardiac patients admitted to a national heart center were readmitted during the first year. Readmission was predicted by patient-reported anxiety, depression, perceived health, quality of life and symptom distress, which may be used in risk assessment in clinical practice.
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