Exploratory Analysis of SPPB as a Potential Prognostic Factor in Elderly Acute Heart Failure Patients

Background The Short Physical Performance Battery (SPPB) test not only provides a precise assessment of rehabilitation but also predicts a clinical prognostic outcome. The aim was to establish a prognostic model for patients with acute heart failure (AHF) based on SPPB. Methods Patients with AHF in Tongji Hospital were screened and enrolled to conduct this retrospective cohort study. Forty‐five potential predictor variables were used in univariate and multivariate Cox regression analysis for all‐cause mortality. The prognostic model was further built with a nomogram, the accuracy of which was evaluated through the consistency index (C‐index), TimeROC curves, calibration curves, and DCA curves. Results Of 108 patients with AHF enrolled, the median follow‐up time was 454.5 days and all‐cause mortality was 53. Multivariate predictors of all‐cause mortality included SPPB, hypertension, rehabilitation, and ACEI/ARB/ARNI medications. The nomogram was developed to predict all‐cause mortality. Consistency between the predicted and actual values in the 1‐ and 2‐year survival calibration curves was excellent, with a C‐index of 0.748. TimeROC AUCs were 0.796 and 0.807 in predicting the 1‐ and 2‐year survival. The DCA curves indicated a higher net clinical benefit compared to the null model. Conclusions This study demonstrated that SPPB, hypertension, rehabilitation, and ACEI/ARB/ARNI medications were independently associated with all‐cause mortality in patients with AHF. Trial Registration: Chinese Registry of Clinical Trials: ChiCTR‐TNRC‐08000235