Patient-reported outcomes at hospital discharge among patients with arrhythmia: Results from the national DenHeart survey

Abstract

Background: Patient-reported outcomes are important predictors of mortality, cardiovascular events and hospitalisation in patients with cardiac diseases, but differences in patient-reported outcomes between groups of patients with arrhythmia have not yet been investigated. Aims: To describe and compare patient-reported outcomes at discharge among patients with different types of cardiac arrhythmia and to examine the associations between demographic characteristics, inhospital factors and patient-reported outcomes. Methods: Data were derived from the national DenHeart study including patient-reported outcomes from the following questionnaires: the hospital anxiety and depression scale (HADS), HeartQoL, short form 12 (SF-12), current health status (EQ-5D), brief illness perception questionnaire (B-IPQ) and the Edmonton symptom assessment scale (ESAS). Clinical and demographic data were obtained from national registers. Multiple linear and logistic regression models were used to investigate the associations between the potential risk factors and the patient-reported outcomes. Results: A total of 4251 patients diagnosed with arrhythmia completed the questionnaire. Across the arrhythmia subgroups, some differences were observed. In general, patient-reported outcome scores were worst among patients with ‘ventricular arrhythmia’ (e.g. highest depression scores and highest prevalence of feeling unsafe at discharge). Regression analysis revealed that longer hospital stay, female gender, being unmarried and having a short education were significantly associated with poor health for almost all arrhythmia subgroups. Conclusion: Differences exist in self-reported health, quality of life and symptom burden across arrhythmia groups with patients with ventricular arrhythmia reporting poorer patient-reported outcomes. Longer hospital stay, female gender, being unmarried and having a low level of education were significantly associated with worse outcomes among the total population.

Association Between Risk Factors and Readmission for Patients With Atrial Fibrillation Treated With Catheter Ablation

“…We found that depression and anxiety symptoms at discharge were associated with readmissions. This is consistent with findings among other groups of patients with heart disease, including those with dysrhythmias 33–35 . Our findings are also comparable with those of the Danish CopenHeart survey, which included patients 6 to 12 months after ablation for AF or atrial flutter and found that all-cause readmissions were associated with symptoms of anxiety (odds ratio, 2.9; 95% CI, 1.7–5.9) and depression (odds ratio, 1.7; 95% CI, 1.0–3.0) 4 .…”

“…This is consistent with findings among other groups of patients with heart disease, including those with dysrhythmias. [33][34][35] Our findings are also comparable with those of the Danish CopenHeart survey, which included patients 6 to 12 months after ablation for AF or atrial flutter and found that allcause readmissions were associated with symptoms of anxiety (odds ratio, 2.9; 95% CI, 1.7-5.9) and depression (odds ratio, 1.7; 95% CI, 1.0-3.0). 4 The mechanisms by which psychological factors lead to readmissions include stimulating the autonomic nervous system, triggering the production of catecholamines, increasing blood pressure, decreasing plasma volume, and contributing to the contraction of coronary arteries, thrombocyte activity, coagulation, and inflammation.…”