DenHeart: Differences in physical and mental health across cardiac diagnoses at hospital discharge

- This is the first study to explore patient-reported outcomes in all diagnostic groups within cardiology.
- Approximately one third of all cardiac patients experience symptoms of anxiety.
- Significant differences exist in patient-reported outcomes across diagnostic groups at discharge.
- The strongest predictors of poor patient-reported outcomes were female sex and high co-morbidity.

ObjectiveTo describe: (i) differences in patient reported physical and mental health outcomes at hospital discharge between a) cardiac diagnostic groups and b) cardiac patients and a national representative reference population and to describe (ii) in-hospital predicting factors for patient reported outcomes.MethodsA national cross-sectional survey combined with national register data. From April 2013 to April 2014 all patients (n = 34,564) discharged or transferred from one of five Danish Heart Centres were invited to participate. 16,712 patients (51%) responded; 67% male and mean age 64 years. All diagnostic groups were represented similar to real life proportions. Patient reported outcome measures included: SF-12, Hospital Anxiety and Depression Scale, EQ-5D, Brief Illness Perception Questionnaire, HeartQoL and Edmonton Symptom Assessment Scale.ResultsStatistically significant differences were found in all patient reported outcomes across diagnostic groups. Listed from worst to best outcomes were heart failure, heart valve disease, ischemic heart disease, infectious heart disease, arrhythmia, congenital heart disease and heart transplant. Also “observation for cardiac disease” scored poorly on some aspects such as anxiety and treatment control. Compared to the reference population, cardiac patients had lower physical and mental health scores. Predicting factors for worse outcomes across diagnoses were female sex, older age, being unmarried, planned admission, longer hospital stay, and higher co-morbidity score.ConclusionsThis large nationwide study finds significant differences in patient reported outcomes across cardiac diagnostic groups, however the differences were small and did not reach minimal important difference. The total population of cardiac patients had significant and clinically relevant poorer scores on mental and physical health than the reference population. Predicting factors for poor outcomes were identified. It is the first study comparing all diagnostic groups within cardiology and it provides important benchmarks between diagnostic groups and future comparisons. This knowledge may help clinicians make better decisions about post-hospital care and prevention.