Abstract 5909: Six Minute Walk Distance Predicts 30 Day Readmission In Hospitalized Heart Failure Patients
While many clinical prediction models in the field of heart failure have been developed to understand risk factors for mortality, clinical determinants of early hospital readmission are not fully understood. Identification of patients at high risk of hospital readmission is critical to refine processes for reducing readmission rates. Prior studies have demonstrated that 6 minute walk distance [6MW] is a predictor of mortality, but thus far has not been used to assess the risk of hospital readmission. We hypothesized that patients with higher 6MW distance at the time of hospital discharge are at low risk for early hospital readmission. We prospectively identified and enrolled 265 patients admitted to the University hospital of Michigan with heart failure and left ventricular systolic dysfunction. Clinical characteristics, laboratory values and demographics were collected for each of the patients at the time of admission and discharge. 6MW testing was administered prior to discharge. Patients who were bed bound were assigned a 6MW distance of zero. Multivariate logistic regression analysis was performed to determine the relationship between 6MW distance and 30 day readmission, controlling for age, gender, clinical characteristics, medications and laboratory values. Patients were grouped as ≤ 400m and > 400m. Results are expressed as mean± S.D., unless indicated otherwise. 204 of the study patients (age 65 3 14 years, female 39%, ejection fraction 26 ± 9%) underwent 6MW testing prior to discharge. Thirty day readmission was 1% for patients with a 6MW > 400m and 16% for patients who walked ≤ 400m [p = 0.0004]. Patients requiring readmission within 30 days [n=21] had a mean 6MW of 120±220m while patients not requiring readmission at 30 days had a 6MW distance of 385± 396m [p= 0.003]. Controlling for clinical variables, 6MW distance > 400m remained a strong predictor of remaining free of readmission at 30 days [OR: 0.257, 95%CI 0.067–0.981, P=0.047]. 6 MW testing offers strong predictive information with respect to early hospital readmission. Programs seeking to produce systems that are effective in reducing early hospital readmission may need to incorporate 6MW test during heart failure hospital care.