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. 2021 Dec 24;86(1):70-78.
doi: 10.1253/circj.CJ-21-0584. Epub 2021 Sep 17.

Barthel Index Score Predicts Mortality in Elderly Heart Failure - A Goal of Comprehensive Cardiac Rehabilitation

Satoshi Katano  1 , Toshiyuki Yano  2 , Katsuhiko Ohori  2   3 , Hidemichi Kouzu  2 , Ryohei Nagaoka  1 , Suguru Honma  4 , Kanako Shimomura  5 , Takuya Inoue  6 , Yuhei Takamura  7 , Tomoyuki Ishigo  8 , Ayako Watanabe  9 , Masayuki Koyama  2   10 , Nobutaka Nagano  2 , Takefumi Fujito  2 , Ryo Nishikawa  2 , Wataru Ohwada  2 , Akiyoshi Hashimoto  2   11 , Masaki Katayose  12 , Sumio Ishiai  13 , Tetsuji Miura  2   14
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Free article

Barthel Index Score Predicts Mortality in Elderly Heart Failure - A Goal of Comprehensive Cardiac Rehabilitation

Satoshi Katano et al. Circ J. .
Free article

Abstract

Background: A strategy to predict mortality in elderly heart failure (HF) patients has not been established.

Methods and results: We retrospectively enrolled 413 HF patients aged ≥65 years (mean age 78 years) who had received comprehensive cardiac rehabilitation (CR) during hospitalization. Basic activities of daily life were assessed before discharge using the Barthel index (BI). Of 413 HF patients, 116 (28%) died during a median follow-up period of 1.90 years (interquartile range 1.20-3.23 years). An adjusted dose-dependent association analysis showed that the hazard ratio (HR) of mortality increased in an almost linear manner as the BI score decreased, and that a BI score of 85 corresponded to an HR of 1.0. Kaplan-Meier survival curves showed that the survival rate was lower for patients with a low BI (<85) than for those with a high BI (≥85; 65% vs. 74%, respectively; P=0.007). In multivariate Cox regression analyses, low BI was independently associated with higher mortality after adjusting for predictors, including B-type natriuretic peptide. Inclusion of the BI into the adjusted model improved the accuracy of the prediction of mortality.

Conclusions: A BI score <85 at the time of discharge is associated with increased mortality independent of known prognostic markers, and achieving functional status with a BI score ≥85 by comprehensive CR during hospitalization may contribute to favorable outcomes in elderly HF patients.

Keywords: Activities of daily living; Barthel Index; Elderly; Heart failure; Mortality.

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