Hongo Yuji, Kitagaki Kazufumi, Futai Rie, Hasegawa Takeshi, Morikawa Hiroshi, Shimoyama Hisashi
Department of Medical Technology, Itami City Hospital, Hyogo, JPN.
Faculty of Rehabilitation, Shijonawate Gakuen University, Osaka, JPN.
Cureus. 2025 Jul 27;17(7):e88846. doi: 10.7759/cureus.88846. eCollection 2025 Jul.
Introduction Poor physical performance is associated with an increased risk of post-discharge cardiovascular events in patients with heart failure. In this study, we investigated the association between physical frailty and improvements in physical performance through cardiac rehabilitation in hospitalized older patients with heart failure. Methods The study included 100 patients with heart failure (aged ≥65 years) hospitalized between January 2023 and August 2024, with a short physical performance battery (SPPB) score ranging from 1 to 11 points at the initiation of cardiac rehabilitation. Patients achieving an improvement of ≥1 SPPB points during hospitalization were classified as the improved group, while those with unchanged or declining scores comprised the non-improved group. We retrospectively examined the association between physical frailty and improvement in physical performance due to acute-phase cardiac rehabilitation during hospitalization. Results Among the 100 patients, 62 and 38 were categorized into the improved and non-improved groups, respectively. Although no significant differences were observed regarding age, sex, or rehabilitation duration between the groups, the prevalence of physical frailty was significantly higher in the non-improved than in the improved group. Modified Poisson regression analysis, controlling for age, sex, and New York Heart Association functional class, showed that physical frailty was significantly associated with a reduced likelihood of improvement in physical performance. Conclusion Physical frailty may inhibit improvement in physical performance among hospitalized older patients with heart failure. Therefore, enhancing acute-phase rehabilitation strategies for patients with frailty and strengthening the post-discharge follow-up system are essential.
引言 身体机能较差与心力衰竭患者出院后心血管事件风险增加相关。在本研究中，我们调查了住院老年心力衰竭患者身体虚弱与通过心脏康复改善身体机能之间的关联。方法 本研究纳入了2023年1月至2024年8月期间住院的100例心力衰竭患者（年龄≥65岁），这些患者在心脏康复开始时简短身体机能量表（SPPB）评分在1至11分之间。住院期间SPPB评分提高≥1分的患者被归类为改善组，而评分未改变或下降的患者则组成未改善组。我们回顾性研究了身体虚弱与住院期间急性期心脏康复导致的身体机能改善之间的关联。结果 在这100例患者中，62例和38例分别被归类为改善组和未改善组。尽管两组之间在年龄、性别或康复时长方面未观察到显著差异，但未改善组的身体虚弱患病率显著高于改善组。在控制年龄、性别和纽约心脏协会心功能分级的修正泊松回归分析中，结果显示身体虚弱与身体机能改善可能性降低显著相关。结论 身体虚弱可能会抑制住院老年心力衰竭患者身体机能的改善。因此，加强针对虚弱患者的急性期康复策略以及强化出院后随访系统至关重要。
