Both depression and self-reported physical health during hospitalization for an acute coronary syndrome predict mortality one year later

Abstract

Background and aims:

Poor patient-rated health status is associated with increased mortality among patients with heart failure. In some patient populations, a single question related to general health has been shown to be a strong predictor of mortality. We examined whether self-reported physical health (PH) in patients hospitalized for an acute myocardial infarction (MI) or unstable angina predicts mortality 1 year later.

Methods:

Prospective observational study of 801 patients assessed with the SF-12 during a hospitalization for MI or unstable angina and followed for 1 year. Two logistic regression equations to predict mortality based on either the PH subscale of the SF-12 or on a single self-rated health (SSRH) item from the SF-12 and controlling for age, gender, diagnosis (MI vs. unstable angina), history of MI, Killip class, and Beck Depression Inventory (BDI) score.

Results:

The 49 patients who died in the first year following the index hospitalization had significantly lower SF-12 PH scores at baseline (33.2 vs. 40.9, p < .01). They also rated their health significantly poorer on the SSRH item (p < .01). The SSRH item was not a significant multivariate predictor of mortality (p = .74). Significant multivariate predictors of 1-year mortality included older age, female gender, history of MI, low BDI score, and SF-12 PH score (all p < .05).

Conclusions:

During a hospitalization for MI or unstable angina, both depression and self-reported physical health on the SF-12, but not a single self-rated health item, predict mortality 1 year later.