Quick Test Helps Predict Hospital Readmission Risk After Heart Attack
TUESDAY, April 23, 2019 (Pharmacist's Briefing) -- For elderly heart attack survivors, how well they perform on a simple mobility test could help predict whether they will be back in the hospital within a month, researchers say.
Nearly one in five of these heart patients are readmitted with complications such as heart failure, bleeding or irregular heart beat within 30 days after leaving the hospital.
The new study included more than 3,000 heart attack patients, average age 81, at 94 U.S. hospitals. Within 30 days of leaving the hospital, about 18% had been readmitted, the findings showed.
Before they left the hospital, patients' thinking, vision, hearing and mobility were assessed. In the mobility assessment, the seniors were timed on how long it took them to rise from a chair, walk 10 feet and then return to the chair.
This "Timed Up and Go" test was the only functional assessment associated with readmission within 30 days.
Patients who took longer than 25 seconds to complete the test were nearly twice as likely to be readmitted than those who did it in under 15 seconds, the researchers found.
Other more traditional risk factors -- including chronic lung disease and heart rhythm disorders -- were also associated with readmission, according to the study published April 23 in the journal Circulation: Cardiovascular Quality and Outcomes.
"Heart attack is one of the conditions specifically identified by Medicare as a priority for readmissions reduction, but so far it's been challenging to predict specifically which patients with heart attack will get readmitted," study author Dr. John Dodson said in a journal news release.
Dodson is director of the New York University Geriatric Cardiology program in New York City.
He suspects that poor performance on the mobility test is a sign of vulnerability to such stresses as infection, falls and recurrent heart events. Dodson also said that "there's considerable overlap between impaired mobility and something called the frailty syndrome, which is generally thought of as an increased vulnerability to these stresses."
But other factors, such as performance of the health system, are important in gauging readmission risk, and the "findings will need to be replicated in future studies," he added.
The American Heart Association has more on heart attack recovery.