Department of Critical Care Medicine and Surgery, Unit of Gerontology and Geriatric Medicine, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
J Card Fail. 2010 May;16(5):390-5. doi: 10.1016/j.cardfail.2010.01.004. Epub 2010 Mar 3.
In older heart failure (HF) patients, survival depends on the severity of their cardiac condition and on their functional status. Lower extremity performance, assessed with the Short Physical Performance Battery (SPPB), predicts survival in older persons, both in epidemiologic and clinical settings. We evaluated whether SPPB predicts long-term survival in older subjects hospitalized for HF, independent of traditional measures of HF severity.
Subjects aged 65+ years were enrolled on discharge after hospitalization for decompensated HF. Participants underwent echocardiography, comprehensive geriatric assessment, and SPPB. Cox proportional hazards regression models were used to predict survival over a 30-month follow-up. Of 157 participants (mean age 80 years, range 65-101; 50% men), 61 died. After adjustment for potential confounders, including demographics, ejection fraction, New York Heart Association classification, and comorbidity, we found a graded independent association between SBBP score and mortality risk: compared with an SPPB score of 9-12, scores of 0, 1-4, and 5-8 were associated with hazard ratios (HR) and 95% confidence interval (CI) of death of 6.06 (2.19-16.76), 4.78 (1.63-14.02), and 1.95 (0.67-5.70), respectively.
SPPB is an independent predictor of long-term survival of older subjects hospitalized for decompensated HF.
在老年心力衰竭（HF）患者中，生存率取决于其心脏状况的严重程度和功能状态。下肢表现，通过短体物理表现电池（SPPB）评估，预测老年人的生存率，在流行病学和临床环境中。我们评估了 SPPB 是否预测了因 HF 而住院的老年患者的长期生存，独立于 HF 严重程度的传统测量。
65 岁以上的受试者在因失代偿性 HF 住院后出院时被纳入。参与者接受了超声心动图，综合老年评估和 SPPB。使用 Cox 比例风险回归模型预测 30 个月随访期间的生存率。在 157 名参与者（平均年龄 80 岁，范围 65-101；50%为男性）中，有 61 人死亡。在调整潜在混杂因素后，包括人口统计学，射血分数，纽约心脏协会分类和合并症，我们发现 SBBP 评分与死亡率风险之间存在分级独立关联：与 SPPB 评分 9-12 相比，评分 0,1-4 和 5-8 与死亡的危险比（HR）和 95%置信区间（CI）分别为 6.06（2.19-16.76），4.78（1.63-14.02）和 1.95（0.67-5.70）。
SPPB 是因失代偿性 HF 住院的老年患者长期生存的独立预测因子。
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