Impact of Oral Treatment on Physical Function in Older Patients Hospitalized for Heart Failure: A Randomized Clinical Trial

Ueda, Kazutaka; Kasao, Masashi; Shimamura, Motoaki; Haruta, Hironori; Nitta, S; Kaneko, Mitsunobu; Uemura, Yukari; Morita, Hiroyuki; Komuro, Issei; Shirai, Tomoyuki

doi:10.1371/journal.pone.0167933

Cited by 9 publications

(13 citation statements)

References 17 publications

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“…28,29 Second, medications to rapidly improve decongestion lead to early ambulation and ADL preservation. 16,30 Third, as our data demonstrated that the albumin level at admission was a predictor of all-cause death, nutritional support might be a key strategy (Table 4). Finally, other approaches, such as educational programs and guideline-based therapy to improve HF prognosis, could contribute to preservation of the ability to perform ADL.…”

Section: Discussionmentioning

confidence: 85%

Prognostic Impact of the Preservation of Activities of Daily Living on Post-Discharge Outcomes in Patients With Acute Heart Failure

Uemura

Shibata

Takemoto

et al. 2018

Circ J

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Section: Discussionmentioning

confidence: 85%

Prognostic Impact of the Preservation of Activities of Daily Living on Post-Discharge Outcomes in Patients With Acute Heart Failure

Uemura

Shibata

Takemoto

et al. 2018

Circ J

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“…This design is consistent with the nature of the research question, which does not aim to evaluate the efficacy of an intervention. Of the remaining three studies, two were Validation/Agreement studies [27,30], and one was a Randomised Controlled Trial (RCT) [31].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…A variety of monitoring devices and algorithms were used, with the ActivPAL (PAL Technologies, Glasgow, UK) being the most commonly used device in studies concerned with posture (5 uses), and the Stepwatch Activity Monitor (Modus health, Washington, US) used most frequently for step count (4 uses). The validity of the methods used was reported by most studies, except for the Mediwalk Pedometer (Terumo, Japan), used by Ueda [31]. The range and validity of outcome measures used is available in Online Resource 4.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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A systematic review of the physical activity levels of acutely ill older adults in Hospital At Home settings: an under-researched field

et al. 2020

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Purpose The purpose of this review was to identify, evaluate and synthesise existing evidence reporting the physical activity levels of acutely ill older patients in a ‘Hospital At Home’ setting and compare this to patients with similar characteristics treated in a traditional hospital inpatient setting. Functional changes and any adverse outcomes due to physical activity (e.g. falls) in both settings where PA was reported or recorded were also evaluated as secondary outcomes. Methods A search strategy was devised for the MEDLINE, CINAHL, AMed, PEDRO, OT Seeker and Cochrane databases. Search results were title, abstract and full-text reviewed by two independent researchers. Data were extracted from included articles using a custom form and assessed for quality and risk of bias using the Appraisal Tool for Cross-Sectional Studies. Results No studies set in the Hospital at Home environments were identified. 16 hospital inpatient studies met the criteria for inclusion. Older patients managed in inpatient settings that would be eligible for Hospital at Home services spent 6.6% of their day active and undertook only 881.8 daily steps. Functional change was reported in four studies with both improvement and decline during admission reported. Conclusion There is a lack of published research on the physical activity levels of acutely-ill older adults in Hospital at Home settings. This review has identified a baseline level of activity for older acutely ill patients that would be suitable for Hospital at Home treatment. This data could be used as a basis of comparison in future hospital at home studies, which should also include functional change outcomes to further explore the relationship between physical inactivity and functional decline.

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“…Ueda et al reported that an early switch from continuous intravenous infusion to oral medication significantly prevented the functional decline during hospitalization. 22 In our study, 82.8% of the patients started TLV therapy from the first day of hospitalization, and the duration of continuous intravenous infusion was significantly shorter in patients treated with TLV therapy.…”

Section: Bed Rest Periodmentioning

confidence: 49%

Efficacy of Tolvaptan in Elderly Patients with Heart Failure and Preserved Ejection Fraction

Suzuki

Murata

Tsujimoto

et al. 2019

Journal of Cardiovascular Emergencies

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Background: There is no known therapy with proven efficacy for improving clinical outcomes in elderly patients with heart failure (HF) and preserved ejection fraction (HFpEF). In this study, we aimed to evaluate the efficacy of tolvaptan (TLV) in elderly HFpEF patients. Methods: This retrospective observational study involved 100 consecutive elderly HFpEF patients hospitalized at the Nagoya Heart Center, Japan. Inclusion criteria were: (1) patients aged ≥75 years; (2) first hospitalization secondary to HF; (3) received medical therapy for HF, without invasive treatment; and (4) clinical follow-up for >6 months after discharge. The primary endpoint was rehospitalization due to worsening HF, and the secondary endpoint was worsening renal function (WRF) during hospitalization and at 6 months after discharge. Sixty background-matched HFpEF patients were divided into 2 groups: with TLV therapy (TLV (+), n = 29) and without TLV therapy (TLV (–), n = 31). In the TLV (+) group, TLV therapy was continued after discharge. Clinical outcomes of these patients were evaluated. Results: Bed rest period and length of hospital stay were significantly shorter in the TLV (+) group than in the TLV (−) group. The dose of loop diuretics, mean serum creatinine levels, and incidence of WRF development were significantly lower in the TLV (+) group. Incidence of rehospitalization was also significantly lower in the TLV (+) group (log-rank test; p = 0.018). The multivariate logistic regression analysis demonstrated that TLV therapy reduces the incidence of rehospitalization in elderly patients with HFpEF. Conclusions: TLV therapy reduced the bed rest period, length of hospital stay, and rate of rehospitalization without WRF in elderly HFpEF patients, suggesting that TLV could represent an effective therapy for this group of patients.

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Impact of Oral Treatment on Physical Function in Older Patients Hospitalized for Heart Failure: A Randomized Clinical Trial

Cited by 9 publications

References 17 publications

Prognostic Impact of the Preservation of Activities of Daily Living on Post-Discharge Outcomes in Patients With Acute Heart Failure

Prognostic Impact of the Preservation of Activities of Daily Living on Post-Discharge Outcomes in Patients With Acute Heart Failure

A systematic review of the physical activity levels of acutely ill older adults in Hospital At Home settings: an under-researched field

Efficacy of Tolvaptan in Elderly Patients with Heart Failure and Preserved Ejection Fraction

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