Tabata Minoru, Shimizu Ryosuke, Kamekawa Daisuke, Kato Michitaka, Kamiya Kentaro, Akiyama Ayako, Kamada Yumi, Tanaka Shinya, Noda Chiharu, Masuda Takashi
Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences.
Int Heart J. 2014;55(4):331-6. doi: 10.1536/ihj.13-224. Epub 2014 Jun 5.
Patients with chronic heart failure (CHF) are frequently readmitted to the hospital due to disease progression. Although a shorter 6-minute walk distance (6MWD) is correlated with poor prognosis, 6MWD is not considered a clinical indicator for predicting hospital readmission.We investigated whether 6MWD measured at the time of hospital discharge predicted readmission due to heart failure in CHF patients.Patients admitted to the hospital for the first time due to heart failure were enrolled. After 6MWD was measured at discharge, patients were followed-up for 3 years. Clinical characteristics, 6MWD and readmission due to heart failure were evaluated in 252 patients (68.5 ± 11.8 years old, 162 males). Significant factors that affected readmission were extracted and cut-off values were determined using multivariate logistic regression analysis and receiver operating characteristic curves.Of 252 CHF patients, 103 were readmitted within 3 years. 6MWD at the time of discharge was significantly shorter in readmitted patients than non-readmitted patients (P < 0.001) and was a significant predictor of readmission (P < 0.001). The odds ratio for readmission was 1.22 (P < 0.001) with each 10-meter decrease in 6MWD. The 6MWD cut-off value was determined to be 390 meters, with a sensitivity of 0.75 and a specificity of 0.77.6MWD measured at the time of discharge is an independent predictor of hospital readmission in CHF patients, with a cut-off value of 390 meters.
慢性心力衰竭（CHF）患者常因疾病进展而再次入院。尽管较短的6分钟步行距离（6MWD）与预后不良相关，但6MWD未被视为预测再次入院的临床指标。我们调查了出院时测得的6MWD是否能预测CHF患者因心力衰竭再次入院的情况。纳入首次因心力衰竭入院的患者。出院时测量6MWD后，对患者进行3年随访。对252例患者（年龄68.5±11.8岁，男性162例）的临床特征、6MWD及因心力衰竭再次入院情况进行评估。采用多因素逻辑回归分析和受试者工作特征曲线提取影响再次入院的显著因素并确定截断值。在252例CHF患者中，103例在3年内再次入院。再次入院患者出院时的6MWD显著短于未再次入院患者（P<0.001），且是再次入院的显著预测因素（P<0.001）。6MWD每减少10米，再次入院的比值比为1.22（P<0.001）。6MWD截断值确定为390米，敏感性为0.75，特异性为0.77。出院时测得的6MWD是CHF患者再次入院的独立预测因素，截断值为390米。
