Early In-Hospital Functional Status Predicts Recovery at Discharge in Older Patients Hospitalized for Acute Decompensated Heart Failure

Central Figure.

Figure 1.. Flowchart for patient enrollment. Consecutive 258 older patients (aged ≥75 years) who were admitted to our institution due to acute decompensated heart failure (ADHF) from March 2019 to April 2022 were screened. We excluded 88 patients from this study: 53 patients who did not maintain physical function (Barthel Index [BI] <70) before admission, and 35 patients for whom information on functional status before and after admission was unavailable. Additionally, we excluded 4 patients because we could not continue their HF treatment due to mental confusion within 1 week of admission. Finally, this study enrolled 166 patients who maintained functional status (BI ≥70) before admission and received a BI assessment every week after admission.

Figure 2.. (A) Comparison of trajectory of Barthel Index (BI) after admission between patients with a BI ≥70 and those without at discharge (all patients). We compared the trajectory of BI recovery after admission between patients with a BI ≥70 (black) and those without at discharge (red) across all study patients. Differences in the week-to-week trend of BI were observed between the 2 groups from the first week after admission. Patients who recovered to a BI ≥70 at discharge showed significantly higher BI values in the first week after admission, and this improvement persisted from the first week onward compared with those who did not. (B) Comparison of trajectory of the BI after admission between patients with a BI ≥70 and those without at discharge (patients discharged after 2 weeks of hospitalization). We also compared the trajectory of BI recovery after admission between patients with a BI ≥70 (black) and those without at discharge (red) among patients discharged after 2 weeks of hospitalization. This patient group consists of 114 patients out of the total 166 enrolled patients, excluding 3 patients who died within 1 week of admission and 49 patients who were discharged within 2 weeks…

Figure 3.. (A) Comparison of event-free survival between patients with a Barthel Index (BI) ≥70 and those without at discharge. We compared the Kaplan–Meier event-free survival curves between patients who achieved functional recovery at discharge and those who did not. Patients who did not achieve functional recovery, defined as a BI score of 70 at discharge, had a significantly worse prognosis than those who did (log-rank P<0.001). (B) Comparison of event-free survival between patients with BI ≥50 and those without 1 week after admission. We compared the Kaplan–Meier event-free survival curves between patients who attained early functional recovery and those who did not. Patients without early functional recovery, indicated by a BI <50 vs. BI ≥50 at 1 week after admission, also had a significantly worse prognosis compared with those with early recovery (log-rank P=0.044).