Predicting Short-term Readmission in Hospitalized Patients with Acute Heart Failure: The Use of 6-minute Walk Test at Discharge.

BACKGROUND

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.

OBJECTIVES

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.

METHODOLOGY

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.

RESULTS

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.