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. 2025 Aug;20(5):1389-1397.
doi: 10.1007/s11739-025-03958-8. Epub 2025 May 16.

Prognostic role of short physical performance battery in elderly hospitalized atrial fibrillation patients

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Prognostic role of short physical performance battery in elderly hospitalized atrial fibrillation patients

Giuseppe Armentaro et al. Intern Emerg Med. 2025 Aug.

Abstract

Atrial Fibrillation (AF) is the most common supraventricular arrhythmia, especially in elderly, in whom may contribute to physical impairment. The Short Physical Performance Battery (SPPB) is particularly important for assessing the overall physical functionality but the prognostic role of functional limitation, assessed with the SPPB, in elderly hospitalized AF patients is unknown. The objective of this study is to assess the potential impact of functional disability, evaluated as SPPB < 8 points, on the prognosis of elderly patients with AF who are hospitalized. In this retrospective analysis, 1004 elderly patients were enrolled, of whom 620 women, with a mean age of 84 ± 7.1 years. The occurrence of cardiovascular events CVEs (non-fatal ischemic stroke, nonfatal myocardial infarction, cardiac revascularization or coronary bypass surgery, and cardiovascular death), total mortality occurrence were evaluated during a median follow-up of 3.2 years. In patients with SPPB ≥ 8 pt, the observed CVEs incidence was 3.8 events/100 patient-year compared to 12.4 events/100 patient-year in those with SPPB < 8 (p < 0.0001). The multivariate analysis model confirmed that SPPB < 8 was associated with an increased risk of CVEs by a factor of 2.78. In addition, the presence of pathological geriatric depression scale, previous use of Vitamin K Antagonists, were associated with an increased risk of CVEs in study participants. In contrast, statin therapy, male sex and renin-angiotensin-aldosterone system inhibitors are associated with a reduced risk of CVEs during follow-up. Hospitalized patients with AF that exhibits pathological SPPB score show a higher risk of CVEs and total mortality.

Keywords: Atrial Fibrillation; DOACs; Elderly; Short physical performance battery.

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Conflict of interest statement

Declarations. Conflicts of interest: The authors declare they have no conflict of interest. Ethical approval: The local Ethical Committee (Comitato etico Regione Calabria “Area Centro”) approved the protocol: code protocol number 2012.63 and 2022.361. The procedures used in this study adhere to the tenets of the Declaration of Helsinki. Informed consent: Informed consent was obtained from all subjects involved in the study. Consent for publication: All authors have read and agreed to the published version of the manuscript.

Figures

Fig. 1
Fig. 1
ROC curve of SPPB as dichotomous value as a predictor of CVES occurrence. ROC receiver operating characteristic; SPPB Short physical performance battery, CVES cardiovascular events
Fig. 2
Fig. 2
Kaplan–Meier survival curve for the two different groups stratified according to SPPB value. SPPB Short physical performance battery, CVEs cardiovascular events

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