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

Author(s): Howie-Esquivel, Jill; Dracup, Kathleen; Whooley, Mary A; McCulloch, Charles; Jin, Chengshi; Moser, Debra K; Clark, Robyn A; Pelter, Michele M; Biddle, Martha; Park, Linda G | Abstract: AimsHeart failure (HF) patients are taught to identify a rapid 5nlb body-weight gain for early detection of cardiac decompensation. Few data support this common advice. The study aim was to determine whether a 5nlb weight gain in 1nweek 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 resultsThis was a secondary analysis of a randomized trial. Patients tracked body weight and HF symptoms using diaries. We included patients adherent to daily diaries g50% over 24nmonths (Nn=n119). Mean age was 69n±n11nyears; 77% (65) were male, and 67% completed diaries. A weight gain of 5nlb over 7ndays 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; Pnln0.0001 vs. HR 1.01, 95% CI 0.88, 1.16; Pn=n0.79]. Increased dyspnoea over 7ndays was associated with a greater risk of ED visits and hospital admissions (HR 9.64, 95% CI 3.68, 25.22; Pnln0.0001 vs. HR 5.89, 95% CI 1.73, 20.04; Pn=n0.01). Higher diary adherence was associated with older age, non-sedentary behaviour, lower depression, and HF knowledge.ConclusionsHeart failure patients are counselled to observe for body-weight gain. Our data do not support that a 5nlb 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.