Rapid 5 lb weight gain is not associated with readmission in patients with heart failure

Jill Howie-Esquivel, Kathleen Dracup, Mary A Whooley, Charles McCulloch, Chengshi Jin, Debra K Moser, Robyn A Clark, Michele M Pelter, Martha Biddle, Linda G Park, Jill Howie-Esquivel, Kathleen Dracup, Mary A Whooley, Charles McCulloch, Chengshi Jin, Debra K Moser, Robyn A Clark, Michele M Pelter, Martha Biddle, Linda G Park

Abstract

Aims: Heart failure (HF) patients are taught to identify a rapid 5 lb body-weight gain for early detection of cardiac decompensation. Few data support this common advice. The study aim was to determine whether a 5 lb weight gain in 1 week and signs and symptoms of HF increased risk for unplanned physician or emergency department (ED) visits or hospital admission in rural HF patients.

Methods and results: This was a secondary analysis of a randomized trial. Patients tracked body weight and HF symptoms using diaries. We included patients adherent to daily diaries >50% over 24 months (N = 119). Mean age was 69 ± 11 years; 77% (65) were male, and 67% completed diaries. A weight gain of 5 lb over 7 days was associated with a greater risk for ED visits but not hospital admission [hazard ratio (HR) 1.06, 95% confidence interval (CI) 1.04, 1.08; P < 0.0001 vs. HR 1.01, 95% CI 0.88, 1.16; P = 0.79]. Increased dyspnoea over 7 days was associated with a greater risk of ED visits and hospital admissions (HR 9.64, 95% CI 3.68, 25.22; P < 0.0001 vs. HR 5.89, 95% CI 1.73, 20.04; P = 0.01). Higher diary adherence was associated with older age, non-sedentary behaviour, lower depression, and HF knowledge.

Conclusions: Heart failure patients are counselled to observe for body-weight gain. Our data do not support that a 5 lb weight gain was associated with hospital admission. Dyspnoea was a better predictor of ED visits and hospital admissions. Daily tracking of dyspnoea symptoms may be an important adjunct to daily weight to prevent hospitalization.

Trial registration: ClinicalTrials.gov NCT00415545.

Keywords: Body weight; Diary; Heart failure; Hospital admission; Self-care.

© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Figures

Figure 1
Figure 1
Study flow diagram.

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Source: PubMed

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