Change in patient-reported physical and mental health after adult CHD interventions: a prospective cohort study.

Abstract

Introduction: Psychosocial challenges are well-described among adults with CHD. Limited literature explores the impact of adults with CHD interventions on patient-reported outcomes. We examined changes in patient-reported mental and physical health status 30 days after a diagnostic or interventional adult with CHD procedure.

Methods: A prospective registry captured patient-reported physical and mental health through the Patient Reported Outcomes Measurement and Information System Global Health Questionnaire before and 30 days after the procedure. Global mental and physical health scores were derived and standardised, with 50 points as the mean of the general U.S. population and a minimal important change of 3 points.

Results: In our sample of 160 patients, patent foramen ovale closure and diagnostic catheterisation of complex CHDs were the most common procedures (44.4% and 35.6%, respectively). Palpitations were a commonly reported symptom before the procedure (21.8%), with increasing proportions at 30-days (34.0%, p = 0.003). At baseline, the median global mental health and global physical health scores were 48.3 [IQR = 43.5-53.3] and 47.7 [IQR = 39.8-54.1], respectively, within one standard deviation of the general U.S. population; there were no significant differences from baseline at 30 days. However, these differences were not uniform; approximately 53% and 72% of patients had a clinically meaningful improvement or decline in their global mental health or global physical health score (>minimal important change of 3).

Conclusion: In this novel investigation, patients experienced both improvement and decline in mental and physical self-reported health after adults with CHD interventions, indicating considerable variability in short-term outcomes. Future analyses should explore predictors of divergent changes in health scores after procedures, to promote patient-centred care.