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Health-related quality of life predicts unplanned rehospitalization following coronary revascularization

Gesundheitsbezogene Lebensqualität als Prädiktor ungeplanter stationärer Wiederaufnahmen nach Koronarrevaskularisation

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Abstract

Background

Health-related quality of life (HRQL) is an increasingly well-recognized measure of health outcome in cardiology. We examined HRQL as a predictor of unplanned rehospitalization for cardiac reasons in patients after coronary revascularization over a period of 3 years.

Patients and methods

Out of 791 patients enrolled in the study, 743 completed the MacNew HRQL questionnaire after coronary revascularization. MacNew HRQL scores were used as predictors of unplanned rehospitalization.

Results

Within the 3-year follow-up period, 125 patients (16.8 %) were rehospitalized. After adjustment for age, gender, and myocardial infarction as the initiating event, there were significant differences in unplanned rehospitalization rates between patients with low or moderate vs. high MacNew HRQL global scores (HR: 1.8, 95 % CI: 1.2–2.7) and both physical (HR: 2.2, 95 % CI: 1.4–3.5) and social (HR: 1.8, 95 % CI: 1.2–2.7) subscale scores.

Conclusion

Poor HRQL assessed after coronary revascularization appears to be a powerful predictor of rehospitalization over a 3-year period.

Zusammenfassung

Hintergrund

Die gesundheitsbezogene Lebensqualität („health-related quality of life“, HRQL) stellt einen zunehmend anerkannten Parameter für die Behandlungsergebnisse in der Kardiologie dar. In der vorliegenden Arbeit wurde die HRQL als ein Prädiktor einer ungeplanten stationären Wiederaufnahme aus kardialen Gründen bei Patienten nach koronarer Revaskularisation über einen Zeitraum von 3 Jahren untersucht.

Patienten und Methoden

Von 791 Patienten, die in diese Studie aufgenommen wurden, füllten 743 den MacNew-HRQL-Fragebogen nach Koronarrevaskularisation aus. Der MacNew-HRQL-Score wurde als Prädiktor der unvorhergesehenen Rehospitalisierung verwendet.

Ergebnisse

Innerhalb der 3-jährigen Nachbeobachtungsdauer wurden 125 Patienten (16,8 %) erneut stationär aufgenommen. Nach Berücksichtigung von Alter, Geschlecht und Herzinfarkt als auslösendem Ereignis zeigten sich signifikante Unterschiede bei der Rate an ungeplanten stationären Wiederaufnahmen zwischen Patienten mit niedrigem bis mittlerem MacNew-HRQL-Gesamtscore im Vergleich zu Patienten mit hohem MacNew-HRQL-Gesamtscore (Hazard Ratio, HR: 1,8; 95 %-Konfidenzintervall, 95 %-KI: 1,2–2,7) sowie physischem (HR: 2,2; 95 %-KI: 1,4–3,5) und sozialem (HR: 1,8; 95 %-KI: 1,2–2,7) Subkalenscore.

Schlussfolgerung

Eine geringe HRQL nach koronarer Revaskularisation scheint ein aussagekräftiger Prädiktor für eine Rehospitalisierung innerhalb von 3 Jahren zu sein.

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Acknowledgments

This work has been supported by an unrestricted grant from Boston Scientific.

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Authors and Affiliations

  1. Department of Interventional Cardiology, Cardiac Disease Management Centre, Academic Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria

    W. Benzer MD, FESC

  2. Reha Sports Institute, Feldkirch, Austria

    W. Benzer MD, FESC & A. Philippi MD

  3. Department of Medical Psychology, Innsbruck Medical University, Innsbruck, Austria

    S. Hoefer PhD

  4. Karl Landsteiner Institute for Scientific Research in Clinical Cardiology, Vienna, Austria

    O. Friedrich PhD

  5. College of Health Sciences, University of Wisconsin, Milwaukee, WI, USA

    N. Oldridge PhD

Authors
  1. W. Benzer MD, FESC
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  2. A. Philippi MD
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  3. S. Hoefer PhD
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  4. O. Friedrich PhD
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  5. N. Oldridge PhD
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Corresponding author

Correspondence to W. Benzer MD, FESC.

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Conflict of interest

W. Benzer, A. Philippi, S. Hoefer, O. Friedrich, and N. Oldridge state that there are no conflicts of interest.

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Benzer, W., Philippi, A., Hoefer, S. et al. Health-related quality of life predicts unplanned rehospitalization following coronary revascularization. Herz 41, 138–143 (2016). https://doi.org/10.1007/s00059-015-4351-y

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  • DOI: https://doi.org/10.1007/s00059-015-4351-y

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