Exercise After Hospitalization Is Associated With Lower Readmission Rates in Older Heart Failure Patients Regardless of Prior Exercise Habits

Background: This study investigated the effects of pre- and post-hospitalization exercise habits on readmission among older (age ≥65 years) heart failure (HF) patients. Methods and Results: The study included 98 older patients who were admitted to Odawara Municipal Hospital because of HF (mean [±SD] age 80.6±7.8 years; 41.8% female). Patients were categorized into 4 groups based on pre- and post-hospitalization exercise habits: persistent non-exercisers; exercise dropouts; new exercisers; and persistent exercisers. Exercise was defined as engaging in ≥30 min of moderate or vigorous exercise at least once a week. The primary outcome was all-cause readmission during the 1-year follow-up period. Twenty (20.4%), 25 (25.5%), 39 (39.8%), and 14 (14.3%) patients were classified as persistent non-exercisers, exercise dropouts, persistent exercisers, and new exercisers, respectively. Of the 98 patients in the study, 46 (46.9%) were readmitted during the 1-year follow-up period. In Cox proportional hazards analyses, newly exercising (hazard ratio [HR] 0.14; 95% confidence interval [CI] 0.03-0.53; P=0.004) and persistent exercising (HR 0.23; 95% CI, 0.09-0.57; P=0.001) remained independent prognostic factors for reduced rates of readmission, even after adjusting for confounding factors. Conclusions: We found that continuing or starting exercise after hospital discharge is associated with lower rates of readmission among HF patients. Regular post-discharge assessments of exercise habits are essential for older HF patients.