A decline in activities of daily living due to acute heart failure is an independent risk factor of hospitalization for heart failure and mortality

• Published in: Journal of cardiology 2019-06, Vol.73 (6), p.522-529
• Main 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
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Elderly; Female; Heart failure; Heart Failure - mortality; Hospitalization - statistics & numerical data; Humans; Male; Proportional Hazards Models; Prospective Studies; Registries; Risk Factors; Social background; Walking
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2018.12.014

•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. 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. 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. 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