Will a Patient be Readmitted? Let His Walking do the Talking

The distance a heart failure patient can walk during a period of six minutes can predict early hospital readmission, according to research published in the Archives of Medical Research. The study found that patients with heart failure and left ventricular systolic dysfunction who could walk more than 400 meters in six minutes were less likely to be readmitted to a hospital than those who were able to walk only 400 meters or less.

As healthcare reform starts to take shape, readmission rates are starting to come under increased scrutiny, and therefore, will become a greater priority at many institutions. Identifying patients with heart failure at high risk of returning to the hospital within 30 days is “critical to refine processes for reducing readmission rates,” wrote Todd M. Koelling, MD, of the University of Michigan, the study’s lead author. Koelling and colleagues hypothesized that patients with a greater 6-minute walk distance at the time of discharge are at low risk for early readmission.

They enrolled 265 patients who were admitted with heart failure and left ventricular systolic dysfunction, administering six-minute walk testing prior to discharge, and performing multivariate logistic regression analysis to determine the relationship between six-minute walk distance and 30-day readmission, stratifying by ≤400 meters and >400 meters.

Of the 210 patients who underwent six-minute walk testing prior to discharge, Koelling and colleagues found that patients with a six-minute walk distance greater than 400 meters demonstrated a 30-day readmission rate of 15.9%, whereas patients with a six-minute walk distance equal to or less than 400 meters had a 30-day readmission rate of 30.3%. Patients requiring readmission within 30 days had a median six-minute walk distance of 30 meters compared with those not requiring readmission at 30 days, who walked 338 meters.

Koelling and colleagues concluded that six-minute walk distance “predicted freedom from readmission at 30 days.” Other independent predictors of 30-day readmission included history of gout, use of angiotensin-converting enzyme inhibitor or accepted alternative, and blood urea nitrogen level. They recommend that institutions looking to reduce early hospital readmission incorporate six-minute walk testing into the care of heart failure patients.

For more articles on the latest data regarding the prevention and management of heart failure, visit HCPLive’s conference coverage of the 14th Annual Scientific Meeting of the Heart Failure Society of America (HFSA). Topics covered include the following:

• What Are the Factors Behind Readmission Rates of HF Patients?
• Building a Successful Exercise Training Program for HF Patients
• Beyond Drugs: New Recommendations for the Everyday Management of HF