title: Self-reported health-related quality of life predicts 5-year mortality and hospital readmissions in patients with ischaemic heart disease.
abstract: BACKGROUND
  Patient health-related quality of life (HRQL) is an important health outcome with lower HRQL associated with adverse events in patients with ischaemic heart disease (IHD).
  
  
  METHODS
  Baseline health-related quality of life was investigated as a predictor of 5-year all-cause mortality and cardiac readmissions in Danish patients with IHD.
  
  
  METHODS
  The international HeartQoL Project survey was designed to develop a core HRQL questionnaire for patients with IHD. Baseline scores on each of the 14 items ultimately included in the HeartQoL questionnaire were linked to Danish national health registries and hazard ratios for mortality and readmissions were estimated using Cox regression models.
  
  
  RESULTS
  Among 938 eligible Danish patients with IHD, 662 (70.6%) participated in the international HeartQoL Project. During the 5-year follow-up, 83 patients died and 196 patients were readmitted. Adjusted analyses showed a significant linear association between all-cause mortality and both lower global HRQL (HR = 1.67, 95% CI: 1.26-2.23; p<0.001) and physical scores (HR=1.71, 1.33-2.21; p<0.001) and between readmission and both lower global (HR=1.73, 1.41-2.12; p < 0.001) and physical scores (HR = 1.63, 1.35-1.96; p < 0.001). A significant, but non-linear, effect was found for emotional HRQL score on outcomes.
  
  
  CONCLUSIONS
  This study shows a significant and linear relationship between lower global and physical HRQL scores in patients with IHD and 5-year all-cause mortality and cardiac readmission.
authors.affiliation: National Institute of Public Health, University of Southern Denmark Department of Cardiology, Holbaek Hospital, Denmark Department of Cardiology, Roskilde Hospital, Denmark tbh@regionsjaelland.dk.
authors.forename: Tina Birgitte
authors.initials: TB
authors.lastname: Hansen
authors.affiliation: National Institute of Public Health, University of Southern Denmark.
authors.forename: Lau Caspar
authors.initials: LC
authors.lastname: Thygesen
authors.affiliation: National Institute of Public Health, University of Southern Denmark Department of Cardiology, Holbaek Hospital, Denmark Department of Cardiology, Rigshospitalet, Denmark.
authors.forename: Ann Dorthe
authors.initials: AD
authors.lastname: Zwisler
authors.affiliation: Department of Cardiology, Roskilde Hospital, Denmark.
authors.forename: Lotte
authors.initials: L
authors.lastname: Helmark
authors.affiliation: Center of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands.
authors.forename: Madelein
authors.initials: M
authors.lastname: Hoogwegt
authors.affiliation: Center of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands.
authors.forename: Henneke
authors.initials: H
authors.lastname: Versteeg
authors.affiliation: Department of Medical Psychology, Innsbruck Medical University, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Höfer
authors.affiliation: College of Health Sciences, University of Wisconsin-Milwaukee, University of Wisconsin School of Medicine and Public Health, and Aurora Cardiovascular Services, Aurora St. Luke's Medical Center, Milwaukee, WI, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Oldridge
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology* / Q000628:therapy; D017711:Nonlinear Dynamics; D010359:Patient Readmission; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D013997:Time Factors
keywords: Health-related quality of life; angina; heart failure; ischaemic heart disease; long-term; mortality; myocardial infarction; readmission