Key result
A 5 lb weight gain over 7 days in heart failure patients was not associated with hospital admission (HR 1.01; 95% CI 0.88-1.16; P=0.79), whereas increased dyspnea strongly predicted admission.
Why the study?
Does a 5 lb weight gain in 1 week predict unplanned physician or emergency department visits or hospital admission in rural heart failure patients?
RCT (n=119)
Does a 5 lb weight gain in 1 week predict unplanned physician or emergency department visits or hospital admission in rural heart failure patients?
A 5 lb weight gain over 7 days in heart failure patients is not associated with hospital admission, whereas increased dyspnea is a stronger predictor of both ED visits and hospital admissions.
Caution against relying on 5-lb weight gain alone for HF admission decisions; leaves open whether dyspnea-focused monitoring improves risk stratification.
AIMS: Heart failure (HF) patients are taught to identify a rapid 5 lb body-weight gain for early detection of cardiac decompensation. Few data support this common advice. The study aim was to determine whether a 5 lb weight gain in 1 week and signs and symptoms of HF increased risk for unplanned physician or emergency department (ED) visits or hospital admission in rural HF patients. METHODS AND RESULTS: This was a secondary analysis of a randomized trial. Patients tracked body weight and HF symptoms using diaries. We included patients adherent to daily diaries >50% over 24 months (N = 119). Mean age was 69 ± 11 years; 77% (65) were male, and 67% completed diaries. A weight gain of 5 lb over 7 days was associated with a greater risk for ED visits but not hospital admission [hazard ratio (HR) 1.06, 95% confidence interval (CI) 1.04, 1.08; P < 0.0001 vs. HR 1.01, 95% CI 0.88, 1.16; P = 0.79]. Increased dyspnoea over 7 days was associated with a greater risk of ED visits and hospital admissions (HR 9.64, 95% CI 3.68, 25.22; P < 0.0001 vs. HR 5.89, 95% CI 1.73, 20.04; P = 0.01). Higher diary adherence was associated with older age, non-sedentary behaviour, lower depression, and HF knowledge. CONCLUSIONS: Heart failure patients are counselled to observe for body-weight gain. Our data do not support that a 5 lb weight gain was associated with hospital admission. Dyspnoea was a better predictor of ED visits and hospital admissions. Daily tracking of dyspnoea symptoms may be an important adjunct to daily weight to prevent hospitalization.
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Howie‐Esquivel et al. (2018) conducted an RCT in Heart failure (n=119). 5 lb weight gain in 1 week was evaluated on Hospital admission (HR 1.01, 95% CI 0.88, 1.16, p=0.79). A 5 lb weight gain over 7 days in heart failure patients was not associated with hospital admission (HR 1.01; 95% CI 0.88-1.16; P=0.79), whereas increased dyspnea strongly predicted admission.
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