PMID- 36856063 OWN - NLM STAT- MEDLINE DCOM- 20230612 LR - 20231121 IS - 1532-5415 (Electronic) IS - 0002-8614 (Linking) VI - 71 IP - 6 DP - 2023 Jun TI - Association of early acute-phase rehabilitation initiation on outcomes among patients aged >/=90 years with acute heart failure. PG - 1840-1850 LID - 10.1111/jgs.18283 [doi] AB - 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. CI - (c) 2023 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society. FAU - Ueno, Kensuke AU - Ueno K AD - The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. AD - Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan. FAU - Kaneko, Hidehiro AU - Kaneko H AD - The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. AD - The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan. FAU - Kamiya, Kentaro AU - Kamiya K AD - Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan. FAU - Okada, Akira AU - Okada A AD - Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. FAU - Itoh, Hidetaka AU - Itoh H AD - The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. FAU - Konishi, Masaaki AU - Konishi M AD - Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan. FAU - Sugimoto, Tadafumi AU - Sugimoto T AD - Department of Clinical Laboratory, Mie University Hospital, Mie, Japan. FAU - Suzuki, Yuta AU - Suzuki Y AD - The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. AD - Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan. FAU - Matsuoka, Satoshi AU - Matsuoka S AD - The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. AD - The Department of Cardiology, New Tokyo Hospital, Matsudo, Japan. FAU - Fujiu, Katsuhito AU - Fujiu K AD - The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. AD - The Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan. FAU - Michihata, Nobuaki AU - Michihata N AD - The Department of Health Services Research, The University of Tokyo, Tokyo, Japan. FAU - Jo, Taisuke AU - Jo T AD - The Department of Health Services Research, The University of Tokyo, Tokyo, Japan. FAU - Takeda, Norifumi AU - Takeda N AD - The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. FAU - Morita, Hiroyuki AU - Morita H AD - The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. FAU - Ako, Junya AU - Ako J AD - Department of Cardiovascular Medicine, Kitasato University School of Medicine, Kanagawa, Japan. FAU - Node, Koichi AU - Node K AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Yasunaga, Hideo AU - Yasunaga H AD - The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan. FAU - Komuro, Issei AU - Komuro I AD - The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230301 PL - United States TA - J Am Geriatr Soc JT - Journal of the American Geriatrics Society JID - 7503062 SB - IM MH - Humans MH - *Activities of Daily Living MH - Retrospective Studies MH - *Heart Failure MH - Hospitalization MH - Patient Readmission MH - Length of Stay OTO - NOTNLM OT - acute heart failure OT - early rehabilitation OT - epidemiology OT - very old EDAT- 2023/03/02 06:00 MHDA- 2023/06/12 06:42 CRDT- 2023/03/01 05:23 PHST- 2023/01/13 00:00 [revised] PHST- 2022/10/12 00:00 [received] PHST- 2023/01/15 00:00 [accepted] PHST- 2023/06/12 06:42 [medline] PHST- 2023/03/02 06:00 [pubmed] PHST- 2023/03/01 05:23 [entrez] AID - 10.1111/jgs.18283 [doi] PST - ppublish SO - J Am Geriatr Soc. 2023 Jun;71(6):1840-1850. doi: 10.1111/jgs.18283. Epub 2023 Mar 1.