Nonaka Yuki, Oike Takayuki, Fujii Ren, Maeda Soichiro, Tanaka Shinichiro, Tabira Kazuyuki
Graduate School of Health Science, Kio University, Koryo, Japan.
Musashigaoka Clinical Research Center, Medical Corporation Tanakakai, Musashigaoka Hospital, 7-15-1 Kusunoki, Kumamoto Kita-Ku, Kumamoto, 861-8003, Japan.
Heart Vessels. 2023 May;38(5):653-661. doi: 10.1007/s00380-022-02216-7. Epub 2022 Dec 9.
The Short Physical Performance Battery (SPPB) is a well-established tool to assess the lower extremity physical performance status. The purpose of this study is to examine the impact of brain natriuretic peptide (BNP) levels and SPPB scores on short-term readmission in older patients with heart failure (HF). This prospective cohort study enrolled 325 patients with HF who were hospitalized for acute decompensated HF between November 2017 and December 2021. Variables were analyzed using the Cox proportional hazards model, receiver operating characteristic (ROC) curve, and Kaplan-Meier analysis. The 107 patients who met the inclusion criteria were divided into readmission (within 90 days of discharge; n = 25) and non-readmission (n = 82) groups. Multivariate analysis revealed that BNP level and SPPB score were independent risk factors for readmission within 90 days after discharge. Patients were classified into three groups according to the BNP and SPPB cutoff values calculated using ROC curves. The risk of readmission was significantly higher in Group 3 (BNP ≥ 384 pg/mL and SPPB ≤ 7 points) than in Group 1 (BNP < 384 pg/mL and SPPB > 7 points; hazard ratio: 27.68, 95% confidence interval: 3.672 - 208.700, P = 0.0012). Our study showed that HF patients with high BNP levels and low SPPB scores have a dramatically increased risk of readmission within 90 days of discharge.
简短体能测试电池(SPPB)是一种成熟的评估下肢身体机能状态的工具。本研究的目的是探讨脑钠肽(BNP)水平和SPPB评分对老年心力衰竭(HF)患者短期再入院的影响。这项前瞻性队列研究纳入了2017年11月至2021年12月期间因急性失代偿性HF住院的325例HF患者。使用Cox比例风险模型、受试者工作特征(ROC)曲线和Kaplan-Meier分析对变量进行分析。符合纳入标准的107例患者分为再入院组(出院后90天内;n = 25)和非再入院组(n = 82)。多因素分析显示,BNP水平和SPPB评分是出院后90天内再入院的独立危险因素。根据使用ROC曲线计算出的BNP和SPPB临界值将患者分为三组。第3组(BNP≥384 pg/mL且SPPB≤7分)的再入院风险显著高于第1组(BNP<384 pg/mL且SPPB>7分;风险比:27.68,95%置信区间:3.672 - 208.700,P = 0.0012)。我们的研究表明,BNP水平高且SPPB评分低的HF患者出院后90天内再入院的风险显著增加。