BACKGROUND AND AIMS: Identification of patients with heart failure (HF) at high risk of hospital readmission is critical to refine processes for reducing readmission rates. We hypothesized that patients with higher 6-min walk (6MW) distance at the time of hospital discharge are at low risk for early readmission. METHODS: We prospectively enrolled 265 patients admitted with HF and left ventricular systolic dysfunction. 6MW testing was administered prior to discharge. Multivariate logistic regression analysis was performed to determine the relationship between 6MW distance and 30-day readmission, stratifying by ≤400 m and >400 m. RESULTS: Two hundred ten patients underwent 6MW testing prior to discharge. Patients with 6MW >400 m had a 30-day readmission rate of 15.9%, whereas patients with 6MW ≤400 m had a 30-day readmission rate of 30.3% (p = 0.016). Patients requiring readmission within 30 days had a median 6MW of 30 m, whereas patients not requiring readmission at 30 days walked 338 m (p = 0.012). 6MW distance predicted freedom from readmission at 30 days (OR: 0.435, 95% CI 0.21-0.9, p = 0.025). Other independent predictors of 30-day readmission included history of gout (0.117, 0.021-0.637, p = 0.013), use of angiotensin-converting enzyme inhibitor or accepted alternative (0.372, 0.169-0.820, p = 0.014) and blood urea nitrogen level (1.019, 1.003-1.035, p = 0.020). CONCLUSIONS: Low 6MW distance predicts early hospital readmission in patients with HF. Programs seeking to produce systems that are effective in reducing early hospital readmission may desire to incorporate 6MW testing during HF hospital care.
BACKGROUND AND AIMS: Identification of patients with heart failure (HF) at high risk of hospital readmission is critical to refine processes for reducing readmission rates. We hypothesized that patients with higher 6-min walk (6MW) distance at the time of hospital discharge are at low risk for early readmission. METHODS: We prospectively enrolled 265 patients admitted with HF and left ventricular systolic dysfunction. 6MW testing was administered prior to discharge. Multivariate logistic regression analysis was performed to determine the relationship between 6MW distance and 30-day readmission, stratifying by ≤400 m and >400 m. RESULTS: Two hundred ten patients underwent 6MW testing prior to discharge. Patients with 6MW >400 m had a 30-day readmission rate of 15.9%, whereas patients with 6MW ≤400 m had a 30-day readmission rate of 30.3% (p = 0.016). Patients requiring readmission within 30 days had a median 6MW of 30 m, whereas patients not requiring readmission at 30 days walked 338 m (p = 0.012). 6MW distance predicted freedom from readmission at 30 days (OR: 0.435, 95% CI 0.21-0.9, p = 0.025). Other independent predictors of 30-day readmission included history of gout (0.117, 0.021-0.637, p = 0.013), use of angiotensin-converting enzyme inhibitor or accepted alternative (0.372, 0.169-0.820, p = 0.014) and blood ureanitrogen level (1.019, 1.003-1.035, p = 0.020). CONCLUSIONS: Low 6MW distance predicts early hospital readmission in patients with HF. Programs seeking to produce systems that are effective in reducing early hospital readmission may desire to incorporate 6MW testing during HF hospital care.
Authors: Richard V Clark; Ann C Walker; Robin L O'Connor-Semmes; Michael S Leonard; Ram R Miller; Stephen A Stimpson; Scott M Turner; Eric Ravussin; William T Cefalu; Marc K Hellerstein; William J Evans Journal: J Appl Physiol (1985) Date: 2014-04-24
Authors: Omar F AbouEzzeddine; Anuradha Lala; Prateeti P Khazanie; Ravi Shah; Jennifer E Ho; Horng H Chen; Peter S Pang; Steven E McNulty; Kevin J Anstrom; Adrian F Hernandez; Margaret M Redfield Journal: Am Heart J Date: 2015-10-20 Impact factor: 4.749
Authors: Jerome L Fleg; Lawton S Cooper; Barry A Borlaug; Mark J Haykowsky; William E Kraus; Benjamin D Levine; Marc A Pfeffer; Ileana L Piña; David C Poole; Gordon R Reeves; David J Whellan; Dalane W Kitzman Journal: Circ Heart Fail Date: 2015-01 Impact factor: 8.790