Pre-Hospital Exercise Habits Improve Outcomes in Elderly Heart Failure Patients
Overview
This study analyzed 1262 elderly heart failure patients and found that those with regular pre-hospital exercise habits had better physical function at discharge and significantly lower all-cause mortality within two years post-discharge. Exercise habits were independently associated with a 25% reduction in mortality risk after adjusting for confounders.
Background
Heart failure prevalence is increasing globally, especially among older adults, leading to high mortality and frequent hospital readmissions. Exercise therapy is well established to improve outcomes in heart failure patients, but most evidence focuses on exercise initiated after diagnosis. The impact of habitual exercise before hospitalization on long-term prognosis remains unclear. This study aimed to fill this gap by evaluating the association between pre-hospital exercise habits and post-discharge outcomes in elderly patients hospitalized for heart failure decompensation.
Data Highlights
Parameter
Exercise Habit Group
No Exercise Habit Group
Number of patients
675 (53.5%)
587 (46.5%)
Grip strength
Higher (exact values not provided)
Lower
Gait speed
Higher
Lower
Short Physical Performance Battery score
Higher
Lower
All-cause mortality (log-rank test)
Significantly lower (P = 0.019)
Higher
Adjusted hazard ratio for mortality
0.75 (95% CI, 0.58–0.98; P = 0.035)
Reference
Key Findings
46.5% of elderly heart failure patients reported no regular exercise habits before hospitalization.
Patients with pre-hospital exercise habits demonstrated significantly better physical function measures at discharge, including grip strength, gait speed, and physical performance scores.
Pre-hospital exercise habits were associated with significantly lower all-cause mortality within two years post-discharge (P = 0.019).
After adjustment for confounders, pre-hospital exercise was linked to a 25% reduction in mortality risk (hazard ratio 0.75; 95% CI 0.58–0.98; P = 0.035).
No significant differences in prior heart failure hospitalizations or comorbidities were observed between exercise and non-exercise groups, suggesting exercise independently influences outcomes.
Clinical Implications
Assessing exercise habits in elderly heart failure patients can aid risk stratification and identify individuals who may benefit from targeted interventions. Encouraging regular physical activity before hospitalization may improve physical function and reduce mortality risk. Integrating habitual exercise assessment into routine clinical evaluation could enhance personalized management strategies for this population.
Conclusion
Pre-hospital exercise habits are significantly associated with better physical function and lower mortality in elderly patients hospitalized for heart failure. These findings underscore the importance of promoting and assessing habitual exercise to improve long-term outcomes in this vulnerable group.
References
FRAGILE-HF Study Group 2024 -- Impact of Pre-Hospital Exercise Patterns on Post-Discharge Outcomes in Elderly Heart Failure Patients
