Patient-reported outcomes predict high readmission rates among patients with cardiac diagnoses. Findings from the DenHeart study
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Published on: June 10, 2025
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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