| アブストラクト | BACKGROUND: Data on the potential benefit of acute-phase rehabilitation initiation in very old (aged >/=90) patients with acute heart failure (AHF) have been scarce. METHODS: We retrospectively analyzed data from the Diagnosis Procedure Combination database, which is a nationwide inpatient database. This study included patients hospitalized for heart failure (HF) from January 2010 to March 2018, those aged >/=90 years, who had a length of stay of >/=3 days, New York Heart Association (NYHA) class of >/=II, and had not undergone major procedures under general anesthesia. Propensity score matching and generalized linear models were used to compare in-hospital mortality, length of stay, 30-day readmission rate due to HF, all-cause 30-day readmission, and improvement in activities of daily living (ADL) between patients with and without an acute-phase rehabilitation initiation, which is defined as the rehabilitation initiation within 2 days after hospital admission. RESULTS: Acute-phase rehabilitation was initiated in 8588 of 41,896 eligible patients. Propensity score matching created 8587 pairs. Patients with acute-phase rehabilitation initiation have lower in-hospital mortality (9.0% vs. 11.2%, p < 0.001). Acute-phase rehabilitation initiation was associated with lower in-hospital mortality (odds ratio, 0.778; 95% confidence interval, 0.704-0.860). Patients with acute-phase rehabilitation initiation have a shorter median length of stay (17 days vs. 18 days, p < 0.001), lower 30-day readmission rate due to HF (5.5% vs. 6.4%, p = 0.011) and all-cause 30-day readmission (10.2% vs. 11.2%, p = 0.036), and better ADL improvement (49.7% vs. 46.9%, p < 0.001). Subgroup analysis revealed consistent results (sex, body mass index, NYHA class, and Barthel Index). CONCLUSIONS: The acute-phase rehabilitation initiation was associated with improved short-term clinical outcomes in patients aged >/=90 years with AHF. |
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| ジャーナル名 | Journal of the American Geriatrics Society |
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| 投稿日 | 2023/3/2 |
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| 投稿者 | Ueno, Kensuke; Kaneko, Hidehiro; Kamiya, Kentaro; Okada, Akira; Itoh, Hidetaka; Konishi, Masaaki; Sugimoto, Tadafumi; Suzuki, Yuta; Matsuoka, Satoshi; Fujiu, Katsuhito; Michihata, Nobuaki; Jo, Taisuke; Takeda, Norifumi; Morita, Hiroyuki; Ako, Junya; Node, Koichi; Yasunaga, Hideo; Komuro, Issei |
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| 組織名 | The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.;Department of Rehabilitation Sciences, Graduate School of Medical Sciences,;Kitasato University, Kanagawa, Japan.;The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan.;Department of Rehabilitation, School of Allied Health Sciences, Kitasato;University, Kanagawa, Japan.;Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate;School of Medicine, The University of Tokyo, Tokyo, Japan.;Department of Medical Science and Cardiorenal Medicine, Yokohama City University;Graduate School of Medicine, Kanagawa, Japan.;Department of Clinical Laboratory, Mie University Hospital, Mie, Japan.;The Department of Cardiology, New Tokyo Hospital, Matsudo, Japan.;The Department of Health Services Research, The University of Tokyo, Tokyo,;Japan.;Department of Cardiovascular Medicine, Kitasato University School of Medicine,;Kanagawa, Japan.;Department of Cardiovascular Medicine, Saga University, Saga, Japan.;The Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/36856063/ |
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