Impact of Physical Function and Exercise Capacity on the Outcomes In Hospitalized Elderly Patients with Acute Heart Failure

Abstract

Background Functional decline due to skeletal muscle abnormalities or frailty in elderly patients with heart failure, demonstrates poor outcomes. The Short Physical Performance Battery (SPPB) is a comprehensive measure of physical performance. Objectives The aim of this study was to examine the prognostic significance of SPPB in comparison with that of the 6-minute walking distance (6MWD) test, in elderly patients hospitalized for acute decompensated heart failure (ADHF). Methods This is a post-hoc analysis from a prospective, observational, multicenter cohort study, that enrolled consecutive elderly ADHF patients. Results were analyzed for 1,192 patients, in whom the SPPB and 6MWD were measured during the hospitalization. Primary outcome measure was defined as a composite of all-cause death and HF readmission till one year after discharge. Results The median age was 81 years, 57.2 % were male and the median left ventricular ejection fraction was 45%. During follow-up, there were 138 deaths and 322 HF readmissions. Patients with lower SPPB scores (0 to 6, n=373) had significantly poorer outcomes than those with higher SPPB scores (7 to 12, n=819) even after adjustment for multivariable factors (adjusted HR: 1.28, 95% CI: 1.01 to 1.61, p=0.049), similar to those with shorter 6MWD ( Conclusions Impaired physical function, assessed by SPPB, was associated with poorer outcomes. Thus, the evaluation of muscular functional capacity is important in the management of elderly patients with ADHF.