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. 2021 Jul 16;1(1):oeab006.
doi: 10.1093/ehjopen/oeab006. eCollection 2021 Aug.

Short physical performance battery vs. 6-minute walking test in hospitalized elderly patients with heart failure

Takeshi Kitai  1   2 , Takayuki Shimogai  3 , W H Wilson Tang  4 , Kentaro Iwata  3 , Andrew Xanthopoulos  5 , Shuto Otsuka  3 , Fumika Nakada  3 , Rina Yokoyama  3 , Kentaro Kamiya  6 , Hiroshi Saito  7   8 , Kazuya Saito  9 , Emi Maekawa  10 , Masaaki Konishi  11 , Yuki Ogasahara  12 , Kentaro Jujo  13 , Hiroshi Wada  14 , Takatoshi Kasai  8   15 , Shinichi Momomura  16 , Chayakrit Krittanawong  17 , John Skoularigis  5 , Filippos Triposkiadis  5 , Nobuyuki Kagiyama  8   18 , Yutaka Furukawa  1 , Yuya Matsue  8   15
Affiliations

Short physical performance battery vs. 6-minute walking test in hospitalized elderly patients with heart failure

Takeshi Kitai et al. Eur Heart J Open. .

Erratum in

Abstract

Aims: Functional decline due to skeletal muscle abnormalities leads to poor outcomes in patients with acute heart failure (AHF). The 6-minute walking test (6MWT) reliably evaluates functional capacity, but its technical difficulty for the elderly often limits its benefits. Although the Short Physical Performance Battery (SPPB) is a comprehensive measure of physical performance, its role in AHF remains unclear. This study aimed to examine the prognostic significance of SPPB compared to the 6MWT in elderly patients hospitalized for AHF.

Methods and results: We retrospectively analysed 1192 elderly patients with AHF whose SPPB and 6MWT were measured during the hospitalization. The primary outcome measure was defined as a composite of all-cause death and heart failure readmission until 1 year after discharge. Patients with lower SPPB scores (0-6, n = 373) had significantly poorer outcomes than those with higher SPPB scores (7-12, n = 819) even after multivariable adjustment [adjusted hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.01-1.61; P = 0.049], similar to those with shorter 6MWT (<median) than those with longer 6MWT (adjusted HR 1.61, 95% CI 1.27-2.04; P < 0.001). Although both SPPB and 6MWT [net reclassification index (NRI) 0.139, P = 0.036 and NRI 0.350, P < 0.001, respectively] exhibited incremental prognostic value over conventional risk factors of HF, the additive prognostic effect of 6MWT was superior to that of SPPB (NRI 0.300, P < 0.001).

Conclusions: Reduced functional capacity assessed by either the SPPB or 6MWT was associated with worse outcomes in hospitalized elderly patients with AHF. The incremental prognostic value over the conventional risk factors was higher in 6MWT than in SPPB.

Trial registration: UMIN000023929.

Keywords: Elderly; Frailty; Functional capacity; Physical function.

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Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
The Kaplan–Meier curve showing a comparison of event-free survival rates due to a composite of all-cause death and heart failure readmission between patients with (A) Short Physical Performance Battery scores lower than < 7 vs. those with scores ≥7 and (B) 6-minute walking distance less than the median value vs. greater than or equal to the median value.
Figure 2
Figure 2
Prevalence and event rates among subgroups according to the Short Physical Performance Battery score and 6-minute walking distance.
None
See this image and copyright information in PMC

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