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.
|Number of pages||7|
|Journal||ESC heart failure|
|State||Published - Feb 2019|
Bibliographical noteFunding Information:
K.D., D.M., and M.P. were funded by the NHLBI and NINR as investigators for the REMOTE-HF trial (5R01HL83176-5). L.G.P. was funded by the National Institutes of Health (1KL2TR001870-01). R.A.C. was funded by the Australian Heart Foundation Future Leader Fellowship (2015 FLF 100847). None of the authors were funded for analysis and the writing of this manuscript.
© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.
- Body weight
- Heart failure
- Hospital admission
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine