Simple Measures of Function and Symptoms in Hospitalized Heart Failure Patients Predict Short-Term Cardiac Event-Free Survival

Abstract

Background. Heart failure (HF) is a prevalent chronic condition where patients experience numerous uncomfortable symptoms, low functional status, and high mortality rates. Objective. To determine whether function and/or symptoms predict cardiac event-free survival in hospitalized HF patients within 90 days of hospital discharge. Methods. Inpatients (N = 32) had HF symptoms assessed with 4 yes/no questions. Function was determined with NYHA Classification, Katz Index of Activities of Daily Living (ADLs), and directly with the short physical performance battery (SPPB). Survival was analyzed with time to the first postdischarge cardiac event with events defined as cardiac rehospitalization, heart transplantation, or death. Results. Mean age was 58.2 ± 13.6 years. Patient reported ADL function was nearly independent (5.6 ± 1.1) while direct measure (SPPB) showed moderate functional limitation (6.4 ± 3.1). Within 90 days, 40.6% patients had a cardiac event. At discharge, each increase in NYHA Classification was associated with a 3.4-fold higher risk of cardiac events (95% CI 1.4–8.5). Patients reporting symptoms of dyspnea, fatigue, and orthopnea before discharge had a 4.0-fold, 9.7-fold, and 12.8-fold, respectively, greater risk of cardiac events (95% CI 1.2–13.2; 1.2–75.1; 1.7–99.7). Conclusions. Simple assessments of function and symptoms easily performed at discharge may predict short-term cardiac outcomes in hospitalized HF patients.

Relationship between Activities of Daily Living and Readmission within 90 Days in Hospitalized Elderly Patients with Heart Failure

“…In patients with HF, a low BMI is known to reduce readmission [ 16 ]. Additionally, the poor NYHA class is associated with readmission within 90 days [ 17 ]. Anemia in patients with HF is a predictor of readmission within 90 days [ 9 , 18 ], and their low hemoglobin levels are likely to result in readmission because of heart load [ 19 , 20 ].…”

Rapid 5 lb weight gain is not associated with readmission in patients with heart failure

“…Investigators did find in a group of hospitalized HF patients that dyspnoea did predict short-term cardiac event-free survival. 25 Another group of investigators found that survival rates were improved with diary use that included daily body-weight monitoring, but hospital readmission rates were not reported. 26 Our data show that increases in dyspnoea for 14 days did confer an increased risk for an office visit.…”

The Association Between Depressive Symptoms and N-Terminal Pro–B-Type Natriuretic Peptide With Functional Status in Patients With Heart Failure

“…1,2 Fatigue and dyspnea, hallmark symptoms of HF, contribute to a significant reduction in quality of life and are indicators of HF severity and worsening prognosis. 2,3 Functional status is considered an important outcome of HF as it describes the impact of HF symptoms on patient’s daily physical function. 3,4 Functional status is an important clinical consideration in HF management.…”