Abstract 12545: Inpatient Physical Therapy Use Among US Veterans Hospitalized for Heart Failure

Abstract

Background: Physical debilitation is a common adverse effect of heart failure (HF) hospitalization and is associated with adverse outcomes. Hypothesis: Inpatient physical therapy (PT) mitigates the adverse effects of HF hospitalization, and improves outcomes in patients hospitalized with HF. Methods: Patients with an index hospitalization for HF at a VA facility between January 1, 2013 to December 31, 2017 were identified. Change in PT use over time was evaluated using the Cochran-Armitage trend test. After propensity matching, the impacts of inpatient PT exposure on 90-day all-cause mortality, and a composite of all-cause mortality and readmission were assessed. Results: Of 44,299 patients admitted with HF, 11,685 (26.3%) received inpatient PT. Compared with those who did not receive PT, those who did were older (70.7 vs 75.8; P<0.001), more frequently White (70.0% vs 74.0%; P<0.001), and had a longer length of stay (3.9 vs 7.4; P<0.001). The proportion of patients who utilized PT increased from 24.9% to 55.4% during the study period (P<0.001). After propensity matching, inpatient PT use was associated with worse all-cause mortality (HR: 1.24 [1.14 - 1.36]; P<0.0001) ( Figure ), and a composite outcome of death or all-cause hospitalization (HR: 1.07 [1.02 - 1.12]; P=0.0038) at 90 days. Conclusions: Inpatient PT use significantly increased from 2013 to 2017. After propensity matching, utilization of PT services was associated with adverse outcomes.