Impact of heart failure on functional recovery after hip fracture

Itagaki, Atsunori; Kakizaki, Ayaka; Funahashi, Masahiro; Sato, Kaori; Yasuhara, Kyoko; Ishikawa, Akira

doi:10.1589/jpts.31.277

Cited by 5 publications

(5 citation statements)

References 23 publications

(27 reference statements)

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“…We found that 21.9% of patients with hip fracture also had heart failure. In two earlier studies, the reported frequencies at which heart failure accompanied hip fractures were 13.9% and 13.3%, respectively [37,38]. The reason for higher frequency of complicating heart failure in the present study may be the different definition of heart failure.…”

Section: Discussioncontrasting

confidence: 49%

Effect of heart failure and malnutrition, alone and in combination, on rehabilitation effectiveness in patients with hip fracture

Tamamura¹,

Matsuura²,

Shiba

et al. 2021

Clinical Nutrition ESPEN

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Background & aims: Heart failure and malnutrition are known to each negatively affect a patient's ability to improve their activities of daily living (ADL) through rehabilitation. Here, we investigated whether the negative effects of malnutrition and heart failure on ADL are additive in patients after hip fracture. Methods: This retrospective observational cohort study included 155 patients with hip fracture admitted to convalescent rehabilitation wards. Nutritional status was measured with the Geriatric Nutritional Risk Index (GNRI). Heart failure was assessed using plasma B-type natriuretic peptide (BNP) levels. Based on their GNRIs and BNP levels, patients were classified into four groups: a high GNRI (!92)-low BNP (<100 pg/ml) group (n ¼ 54); high GNRI-high BNP (!100 pg/ml) group (n ¼ 7); low GNRI (<92)-low BNP group (n ¼ 67); and low GNRI-high BNP group (n ¼ 27). The main outcome was rehabilitation effectiveness (REs). To confirm above hypothesis, heart failure was also assessed by American College of Cardiology/American Heart Association (ACC/AHA) stage classification, whereas nutrition was assessed by Mini Nutritional Assessment Short Form (MNA-SF), either. Results: REs in the high GNRI-low BNP group, high GNRI-high BNP group, low GNRI-low BNP group, and low GNRI-high BNP group were 64.8 ± 22.6%, 36.0 ± 22.0%, 40.6 ± 23.6% and 28.5 ± 25.9%, respectively. REs was higher in the high GNRI-low BNP group than in other three groups, and REs in the low GNRI-low BNP group was higher than in the low GNRI-high BNP group. When we evaluated heart failure by ACC/ AHA stage classification instead of BNP, or evaluated nutrition by MNA-SF instead of GNRI, the similar results were demonstrated. Multiple linear regression analyses revealed that age (p < 0.01), handgrip strength (p < 0.01), GNRI (p < 0.05), and BNP (p < 0.01) were significantly associated with REs. Conclusions: These results suggest that malnutrition and heart failure are independently associated with REs and that they have an additive negative effect on improvement of ADL in elderly patients with hip fractures.

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Section: Discussioncontrasting

confidence: 49%

Effect of heart failure and malnutrition, alone and in combination, on rehabilitation effectiveness in patients with hip fracture

Tamamura¹,

Matsuura²,

Shiba

et al. 2021

Clinical Nutrition ESPEN

View full text Add to dashboard Cite

show abstract

“…Mathew et al [ 12 ] also reported that maximum functional improvement occurs during the first 6 months after rehabilitation in a self-reporting heart failure group, and that this group had a lower level of recovery of transfer ability and locomotion than a group without disease. Itagaki et al [ 13 ] recently reported that hip fracture patients with heart failure showed lower REs during hospitalization than those without heart failure, even after adjustment for confounding factors. These three studies appear to indicate that heart failure negatively affects the ADL improvement achieved through rehabilitation; however, the diagnosis of heart failure in the first two studies was based on self-reported histories, and the diagnosis of heart failure in the third study was retrospectively confirmed based on medical records.…”

Section: Discussionmentioning

confidence: 99%

“…[ 12 ] Similarly, FIM effectiveness was reportedly reduced in hip fracture patients with a history of heart failure. [ 13 ] However, because these two studies relied on self-reported diagnoses of heart failure or retrospectively confirmed heart failure diagnosis based on the medical record, the degree and severity of heart failure during rehabilitation could not be assessed.…”

Section: Introductionmentioning

confidence: 99%

Heart failure assessed based on plasma B-type natriuretic peptide (BNP) levels negatively impacts activity of daily living in patients with hip fracture

et al. 2020

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Several studies have shown that nutrition and muscle strength were associated with functional recovery in patients with hip fracture. However, the impact of heart failure on the improvement of activity of daily living (ADL) in patients with hip fracture have not been fully investigated. The purpose was investigating the effect of heart failure on the ADL improvement by rehabilitation in patients with hip fracture. A total of 116 patients with hip fracture discharged from our convalescent rehabilitation ward were studied. Heart failure was assessed based on plasma B-type natriuretic peptide (BNP) levels on admission. ADL was assessed based on rehabilitation effectiveness (REs), which was calculated using the FIM instrument. Clinical, demographic, and nutritional variables were measured. Multiple regression analysis was performed with REs as the dependent variable; variables showing significant correlation with REs in univariate analyses were selected as independent variables. Based on plasma BNP levels, we assigned 39 patients to a Low group: 22 (17−25) median (interquartile) pg/mL, 39 to a Middle group: 52 (42−65) pg/mL, and 38 to a High group: 138 (93−209) pg/mL. REs, handgrip strength, Hb, albumin, and GNRI were higher and age was younger in the Low group than High group (each p < 0.01, respectively). Multiple linear regression analysis revealed that age (p < 0.05), sex (p < 0.05), handgrip strength (p < 0.01), FOIS at admission (p < 0.01), rehabilitation time per day (p < 0.01), and BNP (p < 0.05) were significantly associated with REs. The effect of rehabilitation on ADL improvement was significantly blunted in the High group compared to the Low group. In conclusion, these results suggest that heart failure assessed based on plasma BNP levels negatively impacts improvements in ADL achieved through rehabilitation in patients with hip fracture.

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“…The MBDS does not include variables concerning New York Heart Association (NYHA) functional class, natriuretic peptide values, left ventricular ejection fraction, or drugs administered for heart failure during hospitalization. The purpose of our study, in contrast to others [ 40 , 41 ], was not to evaluate the functional situation of the patients but rather the association of the presence of heart failure with the in-hospital mortality and readmission.…”

Section: Discussionmentioning

confidence: 98%

Impact of Heart Failure on In-Hospital Outcomes after Surgical Femoral Neck Fracture Treatment

Marco-Martínez

Bernal

Fernández-Pérez

et al. 2021

JCM

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Background: Femoral neck fracture (FNF) is a common condition with a rising incidence, partly due to aging of the population. It is recommended that FNF should be treated at the earliest opportunity, during daytime hours, including weekends. However, early surgery shortens the available time for preoperative medical examination. Cardiac evaluation is critical for good surgical outcomes as most of these patients are older and frail with other comorbid conditions, such as heart failure. The aim of this study was to determine the impact of heart failure on in-hospital outcomes after surgical femoral neck fracture treatment. Methods: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2007–2015. We included patients older than 64 years treated for reduction and internal fixation of FNF. Demographic characteristics of patients, as well as administrative variables, related to patient’s diseases and procedures performed during the episode were evaluated. Results: A total of 234,159 episodes with FNF reduction and internal fixation were identified from Spanish National Health System hospitals during the study period; 986 (0.42%) episodes were excluded, resulting in a final study population of 233,173 episodes. Mean age was 83.7 (±7) years and 179,949 (77.2%) were women (p < 0.001). In the sample, 13,417 (5.8%) episodes had a main or secondary diagnosis of heart failure (HF) (p < 0.001). HF patients had a mean age of 86.1 (±6.3) years, significantly older than the rest (p < 0.001). All the major complications studied showed a higher incidence in patients with HF (p < 0.001). Unadjusted in-hospital mortality was 4.1%, which was significantly higher in patients with HF (18.2%) compared to those without HF (3.3%) (p < 0.001). The average length of stay (LOS) was 11.9 (±9.1) and was also significantly higher in the group with HF (16.5 ± 13.1 vs. 11.6 ± 8.7; p < 0.001). Conclusions: Patients with HF undergoing FNF surgery have longer length of stay and higher rates of both major complications and mortality than those without HF. Although their average length of stay has decreased in the last few years, their mortality rate has remained unchanged.

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Impact of heart failure on functional recovery after hip fracture

Cited by 5 publications

References 23 publications

Effect of heart failure and malnutrition, alone and in combination, on rehabilitation effectiveness in patients with hip fracture

Effect of heart failure and malnutrition, alone and in combination, on rehabilitation effectiveness in patients with hip fracture

Heart failure assessed based on plasma B-type natriuretic peptide (BNP) levels negatively impacts activity of daily living in patients with hip fracture

Impact of Heart Failure on In-Hospital Outcomes after Surgical Femoral Neck Fracture Treatment

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