Abstract 14891: Six-minute Walk Distance Predicts the Readmission due to Decompensated Heart Failure in Early Elderly and Late Elderly Patients With Chronic Heart Failure

Abstract

Background: Patients with chronic heart failure (CHF) are frequently readmitted to the hospital. Six-minute walk distance (6MWD) is a clinical measure to assess their exercise capacity and prognosis. However, few reports documented whether the 6MWD reflects the exercise capacity and prognosis in elderly CHF patients. Purpose: This study aimed to investigate whether the 6MWD measured at the hospital discharge predicted the readmission due to decompensated CHF in early elderly and late elderly CHF patients. Methods: Patients who were admitted to the hospital were prospectively followed up for 3 years after the discharge, if they had the first hospitalization due to CHF with NYHA III or IV. Consequently, we studied 177 patients (74±6 years, 112 males) and investigated their 6MWD at the discharge and readmission over 3 years. Patients were divided into 2 groups: early elderly group (65-74 years; n=108) and late elderly group (≥75 years; n=62). We determined significant factors affecting the readmission due to CHF and their cut-off values in the two groups using multivariate logistic regression analysis and the area under the receiver operating characteristics (ROC) curve. Results: 50 % of early elderly patients and 42 % of late elderly patients were readmitted within 3 year after the discharge. The multivariate logistic regression analysis detected the 6MWD at the discharge as a significant limiting factor for readmission in the two groups (P<0.001, respectively). The odds ratio of readmission with each 10-meter decrease of 6MWD and its cut-off value were 1.34 (P<0.001) and 405 meters for the early elderly group, and 1.37 (P<0.001) and 345 meters for late elderly group, respectively (Figure). Conclusion: This study demonstrated that the 6MWD was shown as a strong predictor for readmission due to decompensated heart failure in elderly patients with CHF. The predictive cut-off values of 6MWD were 405 and 345 meters in the early elderly and late elderly patients, respectively.