Effect of comorbid heart failure on the activities of daily living and walking independence in patients with hospitalization-associated disability after aspiration pneumonia

Purpose In developed countries, the numbers of patients with aspiration pneumonia is increasing as their populations rapidly age, as is the number of patients with heart failure. In addition, aspiration pneumonia in the elderly often develops as a hospitalization-associated disability. The purpose of this retrospective observational cohort study was to investigated the effects of comorbid heart failure on rehabilitation outcomes in patients with hospitalization-associated disability after aspiration pneumonia. Methods This study included 118 patients admitted to convalescent rehabilitation wards with hospitalization-associated disability after aspiration pneumonia. Based on their plasma B-type natriuretic peptide (BNP) levels, patients were classified into non-heart failure (BNP < 100 pg/ml, n = 82) and heart failure (BNP ≧ 100 pg/ml, n = 36) groups. Rehabilitation outcomes were rehabilitation effectiveness (REs) and walking independence rate at discharge. Results REs was higher in the non-heart failure group than the heart failure group (32.0 ± 29.2% vs 20.0 ± 23.0%, p < 0.01). Multiple linear regression analysis with REs as the dependent variable revealed that age (p < 0.05), quadriceps strength (p < 0.05), the Mini Nutritional Assessment Short Form (p < 0.01) and BNP (p < 0.05) were significantly associated with REs. The rate of independent walking at discharge in the non-heart failure group (48.8%) was significantly higher than in the heart failure group (25.0%). Discussion These results suggest that comorbid heart failure has a negative impact on rehabilitation outcomes in patients with hospital-associated disability after aspiration pneumonia. Heart failure assessed based on plasma BNP levels is useful for predicting REs and walking ability at discharge in patients with hospital-associated disability after aspiration pneumonia.