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. 2021 Jun;8(3):1767-1774.
doi: 10.1002/ehf2.13356. Epub 2021 Apr 10.

Prognostic impact of hospital-acquired disability in elderly patients with heart failure

Masakazu Saitoh  1   2 , Yuta Takahashi  3   4 , Daisuke Okamura  4 , Mitsutoshi Akiho  5 , Hidetoshi Suzuki  5 , Naoki Noguchi  6 , Yukito Yamaguchi  6 , Kentaro Hori  2 , Yuichi Adachi  2 , Tetsuya Takahashi  1
Affiliations

Prognostic impact of hospital-acquired disability in elderly patients with heart failure

Masakazu Saitoh et al. ESC Heart Fail. 2021 Jun.

Abstract

Aims: Functional decline is associated with worse outcomes in patients with elderly heart failure (HF), but little is known about the prognostic impact of hospital-acquired disability (HAD) during hospital stay after acute HF. The present study examines the prognostic significance of HAD in the prediction of all-cause mortality in elderly patients who admitted for acute HF.

Methods and results: This retrospective study was performed in 1941 elderly patients aged ≥65 years or older from the cardiovascular physiotherapy for acute HF patients in the Tokyo metropolitan area registry and excluded those who died in hospital. HAD was defined as any decline in the Barthel index (BI) before discharge compared with the BI within 1 month before hospital admission. The primary outcome of this study was all-cause death and HF readmission. A total of 565 (29%) deaths and 789 (41%) HF readmission occurred over a median follow-up period of 1.7 years. A total of 476 patients (25%) had HAD during hospital stay after acute HF. In multivariable analysis, HAD predicted all-cause death [hazard ratio (HR): 1.772; 95% confidence interval (CI): 1.450-2.167; P < 60; 0.001] and with risk of HF readmission (HR: 1.193; 95% CI: 1.005-1.416; P = 0.043) after adjusting for the Meta-analysis Global Group in Chronic Heart Failure risk score.

Conclusions: Hospital-acquired disability is associated with an increased risk of all-cause death and readmission for HF in elderly patients with acute HF.

Keywords: Elderly; Heart failure; Hospital-acquired disability; Prognosis.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
(A) Kaplan–Meier curve showing all‐cause death among elderly patients with HF with and without hospital‐acquired disability. (B) Kaplan–Meier curve showing HF readmission among elderly patients with HF with and without hospital‐acquired disability. HF, heart failure.
See this image and copyright information in PMC

References

    1. Sasaki N, Kunisawa S, Ikai H, Imanaka Y. Differences between determinants of in‐hospital mortality and hospitalisation costs for patients with acute heart failure: a nationwide observational study from Japan. BMJ Open 2017; 7: e013753. - PMC - PubMed
    1. Kanaoka K, Okayama S, Nakai M, Sumita Y, Nishimura K, Kawakami R, Okura H, Miyamoto Y, Yasuda S, Tsutsui H, Komuro I, Ogawa H, Saito Y. Hospitalization costs for patients with acute congestive heart failure in Japan. Circ J 2019; 83: 1025–1031. - PubMed
    1. Okura Y, Ramadan MM, Ohno Y, Mitsuma W, Tanaka K, Ito M, Suzuki K, Tanabe N, Kodama M, Aizawa Y. Impending epidemic: future projection of heart failure in Japan to the year 2055. Circ J 2008; 72: 489–491. - PubMed
    1. Pandey A, Kitzman D, Reeves G. Frailty is intertwined with heart failure: mechanisms, prevalence, prognosis, assessment, and management. JACC Heart Fail 2019; 7: 1001–1011. - PMC - PubMed
    1. Matsushita K, Harada K, Miyazaki T, Miyamoto T, Kohsaka S, Iida K, Yamamoto Y, Nagatomo Y, Yoshino H, Yamamoto T, Nagao K, Takayama M. Younger‐ vs older‐old patients with heart failure with preserved ejection fraction. J Am Geriatr Soc 2019; 67: 2123–2128. - PubMed

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