Barthel Index score predicts mortality in elderly heart failure: a goal of comprehensive cardiac rehabilitation

Abstract Background Accurate prediction of mortality in heart failure (HF) patients is crucial for decision-making regarding HF therapies, but a strategy the elderly has not been established. In addition, although favorable effects comprehensive cardiac rehabilitation (CR) on clinical outcomes and functional status have demonstrated, goal CR during hospitalization reducing remains unclear. Aims We examined whether assessment basic activities daily living (ADL) by Barthel Index (BI), most widely used tool ADL, useful predicting all-cause who received CR. Methods This study was single-center, retrospective observational study. retrospectively 413 aged ≥65 years (mean age, 78±7 years; 50% female) were admitted to our institute management hospitalization. Functional performing ADL ability assessed BI within 3 days before discharge. The endpoint death follow-up period. Results Of patients, 116 (28%) died period median 1.90-years (interquartile range, 1.20–3.23 years). an adjusted dose-dependent association analysis showed that hazard ratio (HR) increases almost linear fashion as score decreases corresponding 1.0 85 (Figure A). To minimize differences potential confounding factors between patient with low (<85) high (≥85), inverse probability treatment weighting (IPTW) calculated using propensity score. Kaplan-Meier survival curves, which selection bias minimized use IPTW confounders, had higher rate than did (≥85) B). multivariate Cox regression analyses, independently associated after adjustment predictors including brain natriuretic peptide prior (IPTW-adjusted HR, 1.75 [95% confidence interval, 1.03–2.98], p<0.001). Inclusion into model improved accuracy (continuous net reclassification improvement, 0.292, p=0.008; integrated discrimination 0.017, p=0.022). Conclusion A <85 at time discharge increased known prognostic markers, achievement ≥85 may contribute outcome patients. FUNDunding Acknowledgement Type funding sources: Public grant(s) – National budget only. Main source(s): Japan Society Promotion Science