A decline in activities of daily living due to acute heart failure is an independent risk factor of hospitalization for heart failure and mortality. Issue 6 (June 2019)

• Record Type: Journal Article
• Authors: Takabayashi, Kensuke; Kitaguchi, Shouji; Iwatsu, Kotaro; Morikami, Yuko; Ichinohe, Tahei; Yamamoto, Takashi; Takenaka, Kotoe; Takenaka, Hiroyuki; Muranaka, Hiroyuki; Fujita, Ryoko; Nakajima, Osamu; Yokoyama, Ryou; Terasaki, Yuka; Nishio, Hideki; Masai, Miho; Koito, Hitoshi; Okuda, Miyuki; Uwatoko, Hirohisa; Kawakami, Yoshihide; Matsumoto, Sen; Kitamura, Tetsuhisa; Nohara, Ryuji
• Is Part Of: Journal of cardiology. Volume 73:Issue 6(2019)
• Page Start: 522
• Page End: 529
• Publication Date: 2019-06
• Subjects: Activities of daily living -- Heart failure -- Elderly -- Social background; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2018.12.014
• Languages: English
• ISSNs: 0914-5087

Abstract

Highlights: A decline in activities of daily living in heart failure predicted poor prognosis. We provide detailed social data on patients with heart failure. Patients with a decline in activities of daily living may require additional support. Taking early-phase cardiac rehabilitation and providing social support were needed. 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.