A decline in activities of daily living due to acute heart failure is an independent risk factor of hospitalization for heart failure and mortality

Abstract

Background: Although activities of daily living (ADL) are recognized as being pertinent in averting relevant readmission of heart failure (HF) and mortality, little research has been conducted to assess a correlation between a decline in ADL and outcomes in HF patients. Methods: The Kitakawachi Clinical Background and Outcome of Heart Failure Registry is a prospective, multicenter, community-based cohort of HF patients. We categorized the patients into four types of ADL: independent outdoor walking, independent indoor walking, indoor walking with assistance, and abasia. We defined a decline in ADL (decline ADL) as downgrade of ADL and others (non-decline ADL) as preservation of ADL before discharge compared with admission. Results: Among 1253 registered patients, 923 were eligible, comprising 98 (10.6%) with decline ADL and 825 (89.4%) with non-decline ADL. Decline ADL exhibited a higher risk of hospitalization for HF and mortality compared with non-decline ADL. A multivariate analysis revealed that decline ADL emerged as an independent risk factor of hospitalization for HF [hazard ratio (HR), 1.42; 95% confidence interval (CI): 1.01-1.96; p = 0.046] and mortality (HR, 1.95; 95% CI: 1.23-2.99; p < 0.01). Although 66.3% of patients with decline ADL were registered for long-term care insurance, few received daycare services (32.7%) or home-visit medical services (8.2%). Conclusions: Decline in ADL is a predictor of hospitalization for HF and mortality in HF patients.

Clinical Implications of Oral Assessment in Elderly Patients with Acute Heart Failure: A Single-center, Retrospective Study

“…Therefore, it is important to identify predictors of ADL decline during hospitalization in patients with HF. It has been demonstrated in elderly patients and patients with HF that age and the nutritional index are associated with ADL decline during hospitalization [33] [34]. Our present study involving elderly patients with HF has shown that the ROAG score serves as a good predictor of changes in ADL, and its predictive ability is comparable to age, nutritional indices, and various other parameters.…”

“…We have previously demonstrated that hospitalization for HF was signi cantly correlated with decreased BI as an assessment of ADL, and a decreased BI during hospitalization was associated with worse clinical outcomes [8]. It has also been reported that a decline in ADL due to acute HF is an independent risk factor of hospitalization for HF and mortality [33]. Therefore, it is important to identify predictors of ADL decline during hospitalization in patients with HF.…”

<p>Barthel Index as a Predictor of Mortality in Patients with Acute Coronary Syndrome: Better Activities of Daily Living, Better Prognosis</p>

“…Previous studies showed the BI score to be a prognostic predictor of heart failure 18 and stroke. 19 A recent study showed that the BI at discharge may be related to one-year mortality of ACS patients >85 years old undergoing PCI.…”

Association between the activities of daily living and clinical outcomes in patients with heart failure

“…The correlation between a decline in activities of daily living (ADL) due to readmission for heart failure (HF) and outcomes among patients with HF was unclear. Recently, we read with great interest the study by Takabayashi et al [1]. The authors performed a prospective, multicenter, community-based cohort study to investigate the association between the ADL and the clinical outcome in HF patients, with the incidence of hospitalization for HF and mortality during the follow-up as primary outcomes.…”