Abstract 17697: Impacts of Postdischarge Physical Activity and its Change During the First 3 Months After Discharge on Long-term Prognosis in Older Japanese Patients With Heart Failure
Introduction: Impacts of postdischarge physical activity (PA) and its change in a short period of time on rehospitalization remain unclear in older heart failure (HF).
Methods: Forty-one patients (average 76±5 yrs) who had been admitted due to HF were prospectively enrolled. PA was measured using the tri-axis accelerometer from the day of discharge for 7 days. At discharge, leg-extensor muscle strength, 6-min walking distance (6MWD), SF-36 score, left ventricular structure, and biomarkers including brain natriuretic peptide were evaluated. PA was repeatedly assessed in those with no adverse events after 3 months postdischarge. Patients were stratified into 3 groups according to the changes in PA from the discharge value; Decreased PA (n=19), Increased PA<20% (n=10), and Increased PA≥20% (n=6). Clinical factors related to HF rehospitalization within 1 year were evaluated. In a subgroup of patients with no adverse events during the first 3 months, clinical factors related to HF rehospitalization were also evaluated.
Results: HF rehospitalization was observed in 2 out of 41 (5%) within 3month and 13 (32%) within 1 year. One sudden death was observed. Multivariate analysis showed that postdischarge PA was the only independent predictor for HF rehospitalization [hazard ratio (HR) 0.84, 95% confidence interval 0.70-0.99]. In a sub-group analysis in those with no adverse events during the first 3 months, 11 rehospitalization were observed within 1 year: 3 in Decreased PA (16%), 7 in Increased PA<20% (70%) , and 1 in Increased PA≥20% (17%). PA change pattern and SF-36 score, but not postdischarge PA, were independently associated with HF rehospitalization (HR 0.01 and 0.03). Increased PA≥20% had significantly lower risk for rehospitalization than Increased PA<20% (p<0.05), while the risk for rehospitalization was similar between Increased PA≥20% and Decreased PA.
Conclusions: Postdischarge PA predicts HF rehospitalization. Patients with a greater PA increase in a short period of time after discharge have better long-term outcome than those with a slight increase in PA. Patients with a decrease in PA would have relatively favorable long-term outcome if they have enough postdischarge PA and have no HF rehospitalization during the first 3 months after discharge.
Author Disclosures: N. Fujimoto: None. S. Miyahara: None. K. Dohi: None. E. Sugiura: None. K. Moriwaki: None. T. Omori: None. N. Kumagai: None. N. Yamada: None. M. Ito: None.
- © 2016 by American Heart Association, Inc.