Factors delaying the progress of early rehabilitation of elderly Japanese patients with heart failure

Background: Although intervention with early cardiac rehabilitation (CR) is recommended for elderly patients treated for acute heart failure (HF), there are patients in whom the progress of early CR will be delayed. The aim of this study was to clarify factors related to the progress of early CR. Methods: We enrolled 180 Japanese inpatients aged ≥ 65 years with HF in the present retrospective cohort study. We set a short-term goal of 30 m of walking at 1 week after the start of early CR. We divided the patients into two groups according to whether this goal was achieved (Achievement group, n= 124) or not (Non-achievement group, n= 56) and compared patients’ characteristics and clinical parameters. Results: There was a significant difference (p< 0.05) between the groups for age, length of hospital stay, Functional Independence Measure at discharge, walking level before hospitalization, rate of co-existence of diabetes mellitus, chronic renal failure, orthopedic disease, use of diuretics, creatinine, Prognostic Nutritional Index, hemoglobin, C-reactive protein, and estimated glomerular filtration rate (eGFR). Furthermore, logistic regression analysis showed that walking level before hospitalization (odds ratio [OR]: 3.144, p= 0.0001) and eGFR (OR: 0.971, p= 0.009) were factors related to the inability to achieve the short-term goal. Conclusion: Our findings suggest that walking level before hospitalization and renal function on admission are factors related to delayed progress in early CR of elderly Japanese patients with HF.