Article Text

PDF
The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures: a report from the Euro Heart Survey on Coronary Revascularisation
  1. Mattie J Lenzen1,
  2. Wilma J M Scholte op Reimer1,
  3. Susanne S Pedersen2,
  4. Eric Boersma1,
  5. Willibald Maier3,
  6. Petr Widimsky4,
  7. Maarten L Simoons1,
  8. Nestor F Mercado1,
  9. William Wijns5,
  10. on behalf of the investigators of the Euro Heart Survey on Coronary Revascularization
  1. 1Department of Cardiology, Thorax Centre, Erasmus Medical Centre, Rotterdam, The Netherlands
  2. 2Center of Research on Psychology in Somatic Diseases, Tilburg University, The Netherlands
  3. 3Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
  4. 4Cardiocenter Vinohrady, Prague, Czech Republic
  5. 5Cardiovascular Center, OLV Ziekenhuis, Aalst, Belgium
  1. Correspondence to:
    Dr M J Lenzen
    Department of Cardiology, Room Ba 561, Erasmus Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands;m.lenzen{at}erasmusmc.nl

Abstract

Objective: Self-perceived health status may be helpful in identifying patients at high risk for adverse outcomes. The Euro Heart Survey on Coronary Revascularization (EHS-CR) provided an opportunity to explore whether impaired health status was a predictor of 1-year mortality in patients with coronary artery disease (CAD) undergoing angiographic procedures.

Methods: Data from the EHS-CR that included 5619 patients from 31 member countries of the European Society of Cardiology were used. Inclusion criteria for the current study were completion of a self-report measure of health status, the EuroQol Questionnaire (EQ-5D) at discharge and information on 1-year follow-up, resulting in a study population of 3786 patients.

Results: The 1-year mortality was 3.2% (n = 120). Survivors reported fewer problems on the five dimensions of the EQ-5D as compared with non-survivors. A broad range of potential confounders were adjusted for, which reached a p<0.10 in the unadjusted analyses. In the adjusted analyses, problems with self-care (OR 3.45; 95% CI 2.14 to 5.59) and a low rating (⩽60) on health status (OR 2.41; 95% CI 1.47 to 3.94) were the most powerful independent predictors of mortality, among the 22 clinical variables included in the analysis. Furthermore, patients who reported no problems on all five dimensions had significantly lower 1-year mortality rates (OR 0.47; 95% CI 0.28 to 0.81).

Conclusions: This analysis shows that impaired health status is associated with a 2–3-fold increased risk of all-cause mortality in patients with CAD, independent of other conventional risk factors. These results highlight the importance of including patients’ subjective experience of their own health status in the evaluation strategy to optimise risk stratification and management in clinical practice.

  • CABG, coronary artery bypass grafting
  • CAD, coronary artery disease
  • EHS-CR, Euro Heart Survey on Coronary Revascularization
  • EQ-5D, EuroQol-5D
  • HRQL, health-related quality of life
  • PCI, percutaneous coronary intervention
  • VAS, visual analogue scale

Statistics from Altmetric.com

Footnotes

  • Published Online First 15 September 2006

  • Competing interest: None.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.