Brain natriuretic peptide levels and short physical performance battery scores independently influence short-term readmission rates in older patients with heart failure

Heart Vessels. 2023 May;38(5):653-661. doi: 10.1007/s00380-022-02216-7. Epub 2022 Dec 9.

Abstract

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.

Keywords: Brain natriuretic peptide; Heart failure; Older adults; Readmission; Short physical performance battery.

MeSH terms

  • Aged
  • Heart Failure* / diagnosis
  • Heart Failure* / therapy
  • Humans
  • Natriuretic Peptide, Brain*
  • Physical Functional Performance
  • Prognosis
  • Prospective Studies

Substances

  • Natriuretic Peptide, Brain