Frail patients with acute decompensated heart failure may benefit from early physical rehab

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Frail patients with acute decompensated heart failure (ADHF) may benefit more from early physical rehabilitation intervention than patients with better frailty status at baseline, according to a study.

In this secondary analysis of data from the Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial including 337 patients ≥ 60 years hospitalized for ADHF, were analyzed to assess whether baseline frailty impacted the benefit of physical rehabilitation. The mean (SD) age of participants was 72 (8) years.

At baseline, 57% (n = 192) of patients were frail and 43% (n = 145) were prefrail.

There was a 2.6-fold larger improvement in Short Physical Performance Battery (SPPB) score in frail patients in the treatment arm for the primary trial endpoint versus prefrail patients.

“Trends consistently favored a larger intervention effect size, with significant improvement among frail vs prefrail participants for 6-minute walk distance, [quality of life], and the geriatric depression score, but interactions did not achieve significance,” the authors wrote.

Pandey A, Kitzman DW, Nelson MB, et al. Frailty and Effects of a Multidomain Physical Rehabilitation Intervention Among Older Patients Hospitalized for Acute Heart Failure: A Secondary Analysis of a Randomized Clinical Trial. JAMA Cardiol. Published online January 04, 2023. doi:10.1001/jamacardio.2022.4903