Abstract 17754: The Impact of Postdischarge Physical Activity on Mid- and Long-Term Rehospitalization of Older Japanese Patients With Heart Failure
Introduction: Regular physical activity (PA) reduces morbidity and mortality in older adults. However, the relationship between postdischarge PA and rehospitalization of older patients with heart failure (HF) has not been fully elucidated.
Methods: Forty-one patients who had been admitted due to decompensated HF (76±5 yrs, 23 male) were prospectively enrolled. Leg-extensor muscle strength, 6-minute walking distance (6MWD), SF-36 score, left ventricular (LV) structure and cardiac biomarkers (brain natriuretic peptide; BNP) were evaluated at discharge. PA were determined for at least 7 days postdischarge by use of tri-axis accelerometer. Clinical predictors for 6-month and 12-month postdischarge HF rehospitalization were assessed using multivariate analysis.
Results: Seven patients (16%) were rehospitalized due to exacerbated HF within 6 months, and 13 patients (30%) were rehospitalized within 12 months. One sudden death was observed 2 months after discharge. Postdischarge PA was significantly lower in patients with HF rehospitalization within 6 months than those with no rehospitalization (6.0±2.3 vs. 10.5±4.4 METs·hour per day, p<0.01). No differences were observed in age, hemoglobin, BNP, estimated glomerular filtration rate, leg-extensor muscle strength, 6MWD, SF-36 score, or LV ejection fraction between the 2 groups (p≥0.17). Multivariate analyses showed that postdischarge PA was the only independent variable related to HF rehospitalization within 6 months [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.47-0.93] and within 12 months postdischarge (HR 0.84, 95% CI 0.70-0.99).
Conclusions: Postdischarge PA was independently associated with mid- and long-term rehospitalization in older HF patients. Postdischarge PA using tri-axis accelerometer could identify patients at high-risk for HF exacerbation, and thus may be used to determine the treatment and follow-up strategy for older HF patients.
Author Disclosures: S. Miyahara: None. N. Fujimoto: 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.