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Measured Physical Activity and 30-Day Rehospitalization in Heart Failure Patients

Waring, Thomas MD; Gross, Katherine MD; Soucier, Richard MD; ZuWallack, Richard MD

Journal of Cardiopulmonary Rehabilitation and Prevention: March 2017 - Volume 37 - Issue 2 - p 124–129
doi: 10.1097/HCR.0000000000000204
Heart Failure
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BACKGROUND: Patients hospitalized with decompensated heart failure are at high risk for readmission within 30 days of discharge. Since physical inactivity is associated with increased health care utilization in other diseases, it may predict rehospitalization in heart failure.

METHODS: In a single-center, prospective study, physical activity was measured following hospital discharge using an accelerometer on the wrist. We then related this activity to the 30-day all-cause rehospitalization rate in heart failure. Each minute of activity was dichotomized into higher or lower intensity, based on a threshold of 3000 vector magnitude units. Counts above this threshold corresponded to a higher level of physical activity. Logistic regression and Kaplan-Meier survival analyses were used to relate the activity group to 30-day readmissions.

RESULTS: Ninety-five patients admitted to a heart failure unit were screened; 61 met inclusion criteria and provided consent. Fifty patients were evaluated. Forty-six percent were male, mean age was 71 ± 15 years, and 46% had left ventricular ejection fraction <40%. Thirty-day all-cause hospitalizations occurred in 13 of these 50 patients (26%). Sixty-six percent and 34% were dichotomized into the higher and lower physical activity groups, respectively, over the first week; the latter were more likely to be readmitted within 30 days, with an OR = 5.0 (95% CI, 1.3-19.1), P = .02.

CONCLUSION: Physical inactivity is related to 30-day all-cause readmissions for heart failure. Further studies are necessary to assess causality and to determine whether treatments directed at increasing physical activity could reduce readmission rate.

Physical activity was measured for 1 month in 50 patients discharged for heart failure, and this was related to 30-day all-cause readmission rate. Lower levels of physical activity over the first week following discharge predicted 30-day hospital readmission: OR = 5.0 (95% CI, 1.3-19.1); P = .02.

University of Connecticut Health Center, Farmington (Drs Waring and Gross); and Congestive Heart Failure Unit (Dr Soucier) and Pulmonary and Critical Care Medicine (Dr ZuWallack), Saint Francis Hospital and Medical Center, Hartford, Connecticut.

Correspondence: Thomas Waring, MD, University of Connecticut Health Center, 236 Farmington Ave, Farmington, CT 06050 (Thomaswaring@yahoo.com).

The authors declare no conflicts of interest.

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