Lower extremity performance measures predict long-term prognosis in older patients hospitalized for heart failure.
BACKGROUND
In older heart failure (HF) patients, survival depends on the severity of their cardiac condition and on their functional status. Lower extremity performance, assessed with the Short Physical Performance Battery (SPPB), predicts survival in older persons, both in epidemiologic and clinical settings. We evaluated whether SPPB predicts long-term survival in older subjects hospitalized for HF, independent of traditional measures of HF severity.


RESULTS
Subjects aged 65+ years were enrolled on discharge after hospitalization for decompensated HF. Participants underwent echocardiography, comprehensive geriatric assessment, and SPPB. Cox proportional hazards regression models were used to predict survival over a 30-month follow-up. Of 157 participants (mean age 80 years, range 65-101; 50% men), 61 died. After adjustment for potential confounders, including demographics, ejection fraction, New York Heart Association classification, and comorbidity, we found a graded independent association between SBBP score and mortality risk: compared with an SPPB score of 9-12, scores of 0, 1-4, and 5-8 were associated with hazard ratios (HR) and 95% confidence interval (CI) of death of 6.06 (2.19-16.76), 4.78 (1.63-14.02), and 1.95 (0.67-5.70), respectively.


CONCLUSIONS
SPPB is an independent predictor of long-term survival of older subjects hospitalized for decompensated HF.
Chiarantini
Daniela
D
Department of Critical Care Medicine and Surgery, Unit of Gerontology and Geriatric Medicine, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
Volpato
Stefano
S
Sioulis
Fotini
F
Bartalucci
Francesca
F
Del Bianco
Laura
L
Mangani
Irene
I
Pepe
Giuseppe
G
Tarantini
Francesca
F
Berni
Andrea
A
Marchionni
Niccolo
N
Di Bari
Mauro
M
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016001:Confidence Intervals; D005260:Female; D016330:Frail Elderly; D006305:Health Status Indicators; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D007558:Italy; D007866:Leg / Q000098:blood supply* / Q000502:physiology; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011594:Psychometrics; D012044:Regression Analysis; D012306:Risk; D013997:Time Factors; D014463:Ultrasonography