Improvement in Nutritional Status is Associated with Achieving an Adequate Gait Speed at Discharge in Elderly Patients Hospitalized with Acute Heart Failure

Background: Elderly patients have impaired physical function, which is further reduced by the incidence of hospitalization for heart failure. In these patients, nutritional status also deteriorates during hospitalization, which may cause impairment in their physical function. In this study, we repeatedly measured physical function using gait speed (GS) during hospitalization, and evaluated the factors including nutritional status that are associated with GS at discharge in elderly patients with acute heart failure who underwent exercise training. Methods: From January to December 2015, we enrolled 93 consecutive patients over 80 years of age who were admitted to our hospital with acute heart failure. A 10 m walking test to measure GS was performed at the beginning of training (first time point) and at discharge (second time point). Nutritional status was assessed using the controlling nutritional status (CONUT) score. Results: At the first time point, five out of 93 patients (5%) had a GS of 30.8 m/s, whereas 24 patients (26%) achieved this speed at the second time point. Univariate logistic regression analysis revealed that age, sex, body weight, ADL before admission, handgrip strength, GS at the first time point, and improvement in CONUT score were associated with a GS of 30.8 m/s at the second time point. In the multivariate analysis, improvement in the CONUT score was associated with a GS of 30.8 m/s at discharge after adjustment for confounding factors. Conclusion: Change in nutritional status during hospitalization is associated with GS at discharge in elderly patients hospitalized with acute heart failure.