Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study

Abstract

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

The prevalence of functional disability and its impact on older adults in the ASEAN region: a systematic review and meta-analysis

“…29,32,37,50) (Supplementary Table2). One study reported findings based on a cross-sectional and a cohort study (36).…”

“…Functional disability was defined as the need for assistance or inability to perform ADL or IADL. Of the 27 studies reporting on ADL, 15 studies used Barthel Index(14, 17, 20-22, 24, 28, 29, 32, 34-36, 43, 48, 50), while several studies reported the use of Katz scale(22,28,29,33,39,42,44) and other ADL assessments. The Lawton and Brody scale was used in 14 studies to assess IADL(14, 17, 26, 27, 30-32, 34, 39, 41-44, 49).…”

The Prevalence of Activities of Daily Living Impairment in Patients With Heart Failure: A Systematic Review and Meta-Analysis

“…In this review, 5 studies were occurred in America (10,(13)(14)(15)(16), 4 in Asia (7,8,12,17) and 3 in Europe (11,18,19). The prevalence of ADL impairment in HF patients ranged from 11.1 to 70.5%.…”

“…ADL ability in HF patients is closely related to their prognosis. A study showed that patients with ADL impairment had an approximately threefold increase in 3-month readmission rates compared to patients without ADL impairment ( 7 ). Another study showed that ADL ability was an independent predictor of all-cause mortality in patients with HF ( 8 ).…”

(Illness perception and its connection with chosen characteristics in heart failure patients)

“…19 Zvláště u starších hospitalizovaných pacientů se srdečním selháním je běžná porucha v oblasti aktivit každodenního života, což je spojeno se zvýšeným počtem rehospitalizací. 20 Ztráta soběstačnosti a negativní změny v oblasti aktivit denního života mohou být u starších pacientů hospitalizovaných pro akutní dekompenzaci srdečního selhání spojeny i s vyšší nemocniční mortalitou. 21 Parametry, jako je soběstačnost pacienta, je proto nutné zhodnotit při přijetí pacienta do péče, aby mohli být identifi kováni rizikoví pacienti s cílem plánovat vhodnou rehabilitační intervenci, která by měla zabránit dalšímu propadu v této oblasti, což by mohlo pomoci zlepšit klinický management tohoto stavu.…”