1 Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Denmark.
2 National Institute of Public Health, University of Southern Denmark, Denmark.
Eur J Prev Cardiol. 2019 Apr;26(6):624-637. doi: 10.1177/2047487318769766. Epub 2018 Apr 11.
Patient-reported quality of life and anxiety/depression scores provide important prognostic information independently of traditional clinical data. The aims of this study were to describe: (a) mortality and cardiac events one year after hospital discharge across cardiac diagnoses; (b) patient-reported outcomes at hospital discharge as a predictor of mortality and cardiac events.
A cross-sectional survey with register follow-up.
Participants: All patients discharged from April 2013 to April 2014 from five national heart centres in Denmark.
Patient-reported outcomes: anxiety and depression (Hospital Anxiety and Depression Scale); perceived health (Short Form-12); quality of life (HeartQoL and EQ-5D); symptom burden (Edmonton Symptom Assessment Scale). Register data: mortality and cardiac events within one year following discharge.
There were 471 deaths among the 16,689 respondents in the first year after discharge. Across diagnostic groups, patients reporting symptoms of anxiety had a two-fold greater mortality risk when adjusted for age, sex, marital status, educational level, comorbidity, smoking, body mass index and alcohol intake (hazard ratio (HR) 1.92, 95% confidence interval (CI) 1.52-2.42). Similar increased mortality risks were found for patients reporting symptoms of depression (HR 2.29, 95% CI 1.81-2.90), poor quality of life (HR 0.46, 95% CI 0.39-0.54) and severe symptom distress (HR 2.47, 95% CI 1.92-3.19). Cardiac events were predicted by poor quality of life (HR 0.71, 95% CI 0.65-0.77) and severe symptom distress (HR 1.58, 95% CI 1.35-1.85).
Patient-reported mental and physical health outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses.
患者报告的生活质量和焦虑/抑郁评分提供了独立于传统临床数据的重要预后信息。本研究的目的是描述：（a）在心脏诊断后一年内出院的死亡率和心脏事件；（b）出院时患者报告的结果作为死亡率和心脏事件的预测指标。
横断面调查与登记随访。
参与者：所有于 2013 年 4 月至 2014 年 4 月从丹麦五个国家心脏中心出院的患者。
患者报告的结果：焦虑和抑郁（医院焦虑和抑郁量表）；感知健康（简短形式 12）；生活质量（心脏 QoL 和 EQ-5D）；症状负担（埃德蒙顿症状评估量表）。登记数据：出院后一年内的死亡率和心脏事件。
出院后第一年，在 16689 名应答者中有 471 人死亡。在不同的诊断组中，报告有焦虑症状的患者在调整年龄、性别、婚姻状况、教育水平、合并症、吸烟、体重指数和酒精摄入量后，其死亡率增加一倍（风险比（HR）1.92，95%置信区间（CI）1.52-2.42）。对于报告有抑郁症状（HR 2.29，95%CI 1.81-2.90）、生活质量差（HR 0.46，95%CI 0.39-0.54）和严重症状困扰（HR 2.47，95%CI 1.92-3.19）的患者，也发现了类似的死亡率增加风险。心脏事件由生活质量差（HR 0.71，95%CI 0.65-0.77）和严重症状困扰（HR 1.58，95%CI 1.35-1.85）预测。
患者报告的身心健康结果是独立预测心脏诊断后一年内死亡率和心脏事件的指标。
