Patient-reported predictors of postdischarge mortality after cardiac hospitalization.
J Hosp Med
; 19(6): 475-485, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38560772
ABSTRACT
BACKGROUND:
Adults hospitalized for cardiovascular events are at high risk for postdischarge mortality. Screening of psychosocial risk is prioritized by the Joint Commission. We tested whether key patient-reported psychosocial and behavioral measures could predict posthospitalization mortality in a cohort of adults hospitalized for a cardiovascular event.METHODS:
We conducted a prospective cohort study to test the prognostic utility of validated patient-reported measures, including health literacy, social support, health behaviors and disease management, and socioeconomic status. Cox survival analyses of mortality were conducted over a median of 3.5 years.RESULTS:
Among 2977 adults hospitalized for either acute coronary syndrome or acute decompensated heart failure, the mean age was 53 years, and 60% were male. After adjusting for demographic, clinical, and other psychosocial factors, mortality risk was greatest among patients who reported being unemployed (hazard ratio [HR] 1.99, 95% confidence interval [CI]) 1.30-3.06), retired (HR 2.14, 95% CI 1.60-2.87), or unable to work due to disability (HR 2.36, 95% CI 1.73-3.21), as compared to those who were employed. Patient-reported perceived health competence (PHCS-2) and exercise frequency were also associated with mortality risk after adjusting for all other variables (HR 0.86, 95% CI 0.73-1.00 per four-point increase in PHCS-2; HR 0.86, 95% CI 0.77-0.96 per 3-day increase in exercise frequency, respectively).CONCLUSIONS:
Patient-reported measures of employment status, perceived health competence, and exercise frequency independently predict mortality after a cardiac hospitalization. Incorporating these brief, valid measures into hospital-based screening may help with prognostication and targeting patients for resources during post-discharge transitions of care.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Alta do Paciente
/
Hospitalização
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article