Physician, Koodankulam Government Hospital, Tirunelveli District; Consultant Physician, Department of Medicine, Dr. Jeyasekharan Medical Trust, Kanyakumari District;Corresponding Author.
Professor.
J Assoc Physicians India. 2023 Feb;71(2):11-12. doi: 10.5005/japi-11001-0174.
Hospitalization is an important landmark in the history of heart failure. Patients admitted for acute heart failure have a high chance of readmission. We require predictors which can foresee readmission. Functional capacity assessment by the 6-minute walk test is one such predictor.
To compare the mean 6-minute walk distance among acute heart failure patients readmitted within 30 days, those readmitted within 60 days, those readmitted within 90 days, and those not readmitted at 90 days following discharge after the first admission.
This is a follow-up study conducted in Madras Medical College from March 2021 to August 2021. The study included patients who were admitted for the first time in their life for acute heart failure. The clinical details were noted, and the patients were managed as per standard protocols. Before discharge, a 6-minute walk test was performed. The patients were followed up at the end of 30, 60, and 90 days.
25% of the patients had one readmission at the end of 90 days. Majority of readmissions occurred at the end of 30 days. A low 6-minute walk distance at discharge was a significant predictor of readmission at the end of 30 days. A distance of 200 m was a reasonable cutoff in our population. A lower time walked was also a significant predictor of readmission at the end of 30 days. A slower walking speed was also a significant predictor of readmission at the end of 30 days. Some other parameters such as a longer duration of stay, a longer duration of intravenous (IV) diuretic requirement, discharge respiratory rate, and lower serum albumin at admission were also significant predictors of readmission at the end of 30 days.
住院是心力衰竭病史中的一个重要里程碑。因急性心力衰竭住院的患者再入院的可能性很高。我们需要能够预测再入院的指标。6 分钟步行试验的功能能力评估就是这样一个预测指标。
比较首次入院后 30 天内、60 天内、90 天内再入院的急性心力衰竭患者以及 90 天未再入院的患者的平均 6 分钟步行距离。
这是一项在马德拉斯医学院进行的随访研究，时间为 2021 年 3 月至 2021 年 8 月。研究纳入了首次因急性心力衰竭住院的患者。记录患者的临床资料，并按照标准方案进行治疗。在出院前进行 6 分钟步行试验。在 30 天、60 天和 90 天结束时对患者进行随访。
90 天结束时，25%的患者有一次再入院。大多数再入院发生在 30 天结束时。出院时 6 分钟步行距离较短是 30 天内再入院的显著预测指标。在我们的人群中，200 米是一个合理的截断值。行走时间较短也是 30 天内再入院的显著预测指标。行走速度较慢也是 30 天内再入院的显著预测指标。其他一些参数，如住院时间较长、静脉（IV）利尿剂需求时间较长、出院呼吸频率较高以及入院时血清白蛋白较低，也是 30 天内再入院的显著预测指标。
