High readmission rates and mental distress after infective endocarditis — Results from the national population-based CopenHeart IE survey

Background Infective endocarditis (IE) is a severe disease requiring lengthy hospitalisation. Little is known about patients' recovery after IE. The aims of this study in IE patients were; (i) to describe mortality, readmission, self-reported health and rehabilitation up to 1 year post-discharge, (ii) to examine associations between self-reported health and readmission, and (iii) to investigate predictors of readmission and mortality. Methods All adults treated for IE in Denmark, January–June 2011 (N = 347), were followed in registers. Eligible individuals (n = 209) were invited to participate in a questionnaire survey (responders n = 122). Responses were compared with those of a background reference population and a heart valve surgery population. Mortality and readmission data from registers 12 months post-discharge were investigated. Results Patients discharged after treatment for IE had a mortality of 18% (95% confidence interval (CI): 14%–23%) one year post-discharge and 65% (95% CI: 59%–71%) had been readmitted, the majority (82%) acutely. Patients had lower self-reported health compared to the background population (physical component scale (PCS); mean (standard deviation (SD)): 42.2 (11.1) vs. 47.1 (12.1), (p = 0.0004), mental component scale (MCS); 50.1 (11.7) vs. 53.8 (9.2), (p = 0.006), and more were sedentary (29 vs. 15%), (p = 0.002). Large proportions had clinical signs of anxiety and depression, 25% and 22% respectively, exceeding a hospital anxiety and depression scale (HADS) cut-off score of 8. Almost half (47%) had not been offered cardiac rehabilitation (CR). Conclusions After IE, mortality and readmission rates were high and self-reported physical and mental health poor. These findings call for changes in in-hospital and post-discharge management. © 2017 Elsevier Ireland Ltd