Effectiveness of Early Rehabilitation for Acute Heart Failure A RETROSPECTIVE COHORT STUDY

Purpose: This study sought to investigate the impact of early rehabilitation on activities of daily living in patients with acute heart failure. Methods: This retrospective cohort study utilized a hospital-based database created by the Japan Medical Data Center and contained Diagnosis Procedure Combination survey data from more than 100 participating acute care hospitals across Japan. Data were extracted on consecutive inpatients hospitalized because of acute heart failure from 2014 to 2017. The characteristics and outcomes between patients who underwent early rehabilitation (early rehabilitation group) were compared with those who did not undergo rehabilitation (no rehabilitation group). The primary outcome measure was Barthel Index decline. Results: After applying exclusion criteria, a total of 8351 eligible patients with acute heart failure were included in this study. Significantly more Barthel Index decline (18.7% vs 12.4%, P<.001) was seen in patients in the no rehabilitation group than in those in the early rehabilitation group. Multiple linear regression analysis showed that early rehabilitation was negatively associated with Barthel Index decline after adjustment (OR = 0.57; 95% CI, 0.46-0.67). Conclusion: This study showed that early rehabilitation could possibly be a feasible alternative for maintenance of the Barthel Index in patients with acute heart failure.