Clin Epidemiol. 2014 Jan 30;6:61-70. doi: 10.2147/CLEP.S54237. eCollection 2014.
Patient-reported health as a prognostic factor for adverse events following percutaneous coronary intervention.
Clinical epidemiology
Karin Biering, Hans Erik Bøtker, Troels Niemann, Niels Henrik Hjollund
Affiliations
Affiliations
- Department of Occupational Medicine, Regional Hospital West Jutland, Herning, Denmark.
- Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
- Department of Cardiology, Regional Hospital West Jutland, Herning, Denmark.
- WestChronic, Regional Hospital West Jutland, Herning, Denmark ; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
PMID: 24511242
PMCID: PMC3915019 DOI: 10.2147/CLEP.S54237
Abstract
OBJECTIVE: A relation may exist between self-reported health and adverse events in coronary heart disease. Previous studies have been vulnerable to possible selection bias. In the study reported here, we examined the association between self-rated health and adverse events in terms of cardiac events, cardiac readmissions, and all-cause mortality in a complete cohort of patients treated with percutaneous coronary intervention (PCI).
STUDY DESIGN AND SETTING: A cohort of patients with coronary heart disease treated with PCI was followed up with questionnaires 4 weeks after PCI to measure self-rated health and in registers to identify adverse events. Of 1,752 eligible patients under 67 years, 26 died during the first 4 weeks. A total of 224 patients were excluded from the analysis because they were readmitted with a cardiac diagnosis before answering the first questionnaire. We received complete SF-12 Health Survey component summaries from 984 of the remaining 1,502 patients. We used multiple imputation to establish a complete cohort, including nonrespondents.
RESULTS: During follow-up, 83 patients died, 220 patients experienced a new cardiac event, and 526 patients experienced a hospital readmission related to coronary heart disease. Poor self-rated health was related to cardiac events, cardiac readmission, and all-cause mortality. The associations were stronger for all-cause mortality than for events and readmissions. Physical health was more important than mental health, but both revealed an exposure-response pattern.
CONCLUSION: Poor self-reported health within 4 weeks of PCI was associated with adverse outcomes during up to 5 years' follow-up.
Keywords: SF-12 adverse events; coronary heart disease; mortality; multiple imputation; patient-reported outcomes
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