Predictors of activities of daily living at discharge in elderly patients with heart failure with preserved ejection fraction.

ABSTRACT

The purpose of this study was to clarify the predictive factors of activities of daily living (ADL) at discharge in elderly patients with heart failure with preserved ejection fraction (HFpEF). Participants were selected from among 598 consecutive hospitalized HF patients based on certain criteria. We investigated patient characteristics, and ADL with the motor and cognitive items of the Functional Independence Measure (FIM). We analyzed the data with the unpaired t test, Mann-Whitney U test, χ2 test, logistic regression analysis, and receiver operating characteristic (ROC) curves. We included 154 patients for further analyses who were divided into the low ADL group (n = 75) and high ADL group (n = 79). There were significant differences between the two groups in age, long-term care insurance (LTCI) level, New York Heart Association class, creatinine level, albumin level, ß-blocker, sitting, standing and walking exercise start days, length of hospital stay, and motor- and cognitive-FIM scores at admission and discharge (p < 0.05). The cutoff values of the ROC curves predicting ADL at discharge were LTCL support level 2 (area under the curve [AUC] 0.672, p < 0.001, sensitivity 0.573, false-positive rate 0.278); walking exercise start day 4.5 days (AUC 0.694, p < 0.001, sensitivity 0.609, false-positive rate 0.299); motor FIM score 34.5 points (AUC 0.710, p < 0.001, sensitivity 0.633, false-positive rate 0.280); and cognitive FIM score 28.5 points (AUC 0.806, p < 0.001, sensitivity 0.759, false-positive rate 0.227). This study revealed several predictors of ADL at discharge and their associated cutoff values in elderly patients with HFpEF.