Influence of health-related quality of life in myocardial infarction with regard to the time from symptom onset to hospital arrival, and the risk of re-admission

• Background: Despite increased awareness of the importance of early treatment in acutemyocardial infarction (AMI), the delay from symptom onset until hospital arrival is still too longand re-hospitalisations are frequent. Little is known about how health-related quality of life(HRQL) affects delay time and the frequency of re-admissions.Method: We used quality registers to investigate whether patients’ HRQL has any impact ondelay time with a new AMI, and on the rate of re-admissions during the first year. AMI-patients<75 years, with HRQL assessed with EQ-5D at one-year follow-up, and who thereafter had anew AMI registered, were evaluated for the correlation between HRQL and delay time (n=454).The association between HRQL and re-admissions was evaluated among those who had anadditional one-year follow-up registration after the new AMI (n=216).Results: Patients who reported poor total health status (EQ-VAS ≤50), compared to those whoreported EQ-VAS 81-100, had tripled risk to delay ≥2 hours from symptom onset to hospitalarrival (adjusted OR 3.01, 95% CI: 1.43-6.34). Patients scoring EQ-VAS ≤50 had a higher riskof re-admissions in the univariate analysis (OR 3.08, 95% CI: 1.71-5.53). However, thecorrelation did not remain significant after adjustment (OR 1.99, 95% CI: 0.90-4.38). EQ-indexwas not independently associated with delay time or re-admissions.Conclusion: Aspects of total health status post-AMI were independently associated with delaytime to hospital arrival in case of a new AMI. However, the influence of total health status on therisk of re-admissions was less clear.

Nyckelord

AMI

quality of life

delay time

re-admission

depression

anxiety

MEDICINE

MEDICIN

Publikations- och innehållstyp

vet (ämneskategori)

ovr (ämneskategori)