A Trial of Rehabilitation Therapy in Older Acute Heart Failure Patients

The Short Physical Performance Battery is scored on a scale of 0-12, with a higher score indicating better physical function.

Number of all-cause rehospitalizations 6 months from index hospital discharge.

Exploratory outcome. Distance walked in 6 minutes.

Exploratory outcome. Handgrip strength is measured in kilograms by a handgrip dynamometer.

Exploratory outcome. Frailty is assessed by the Fried criteria consisting of 5 components: low physical activity, exhaustion, weakness, slowness, and unintentional weight loss. Presence of 3 or more Fried criteria indicates frailty, 1-2 criteria indicates pre-frailty, and 0 criteria indicates no frailty.

Exploratory outcome. The KCCQ Overall Summary Summary Score is a heart failure disease-specific quality of life measure encompassing domains of physical limitation, HF symptoms, quality of life, and social limitation scored on a scale of 0-100 with higher scores indicating better health status.

Exploratory outcome. The Physical Limitation Score of the KCCQ questionnaire is a subscore evaluating disease-specific physical limitation. Scores range 0-100 with a higher score indicating less physical limitation.

Exploratory outcome. The SF-12 is a quality of life assessment with 2 component scores (Physical Composite Score and Mental Composite Score) ranging 0-100 with higher scores indicating better health status.

Exploratory outcome. The EQ-5D-5L is a quality of life tool with 5 components designed to detect health utilities: mobility, usual activities, self-care, pain/discomfort, and anxiety/depression. All components are rated on a scale of 1-5 with higher scores indicating worse health status.

Exploratory outcome. The Geriatric Depression Scale is a 15-item questionnaire evaluating depressive symptoms. Scores range from 0-15 with a higher score indicating more severe depressive symptoms.

Exploratory outcome. The Montreal Cognitive Assessment is a tool for assessing multiple domains of cognitive function. Scores range 0-30 with higher scores indicating better cognitive function. A score greater than or equal to 26 is considered normal cognitive function.

Exploratory outcome. Number of all-cause rehospitalizations 1 month post index hospitalization discharge.

Exploratory outcome. Number of all-cause rehospitalizations 3 months after discharged from index hospitalization

Exploratory outcome. Combined number of all-cause rehospitalizations and death 6 months after discharge from index hospitalization

Exploratory outcome. Number of heart failure rehospitalizations 6 months after discharge from index hospitalization

Exploratory outcome. Total days spent hospitalized after date of randomization.

Exploratory outcomes. Total days alive spent outside of hospital, observation unit, acute rehab setting, and skilled nursing facility 6 months after discharge from index hospitalization.

Exploratory outcomes. Number of emergency department visits after 6 months from hospital discharge

Exploratory outcome. Number of observation unit stays <24 hours 6 months after discharge from index hospitalization

Exploratory outcome. Number of unscheduled urgent medical visits after discharge from index hospitalization

Exploratory outcome. The global rank composite outcome combines non-commensurate endpoints including death, number of all-cause rehospitalizations, and month 3 SPPB into a single non-parametric outcome in a hierarchical manner with death being ranked first and SPPB being ranked last. Participants are ranked from the most adverse response (lowest rank) to the most favorable response (highest rank).

Exploratory outcome. Number of placements at skilled nursing facilities after discharge from index hospitalization.

Exploratory outcome. Physical activity assessed by accelerometry quantified in moderate-vigorous physical activity minutes per day.

Exploratory outcome. The Life Orientation Test-Revised is a assessment of generalized optimism scored on a scale of 0-24 with higher scores indicating higher optimism.

Assess direct medical costs, direct non-medical costs, indirect patient time costs, short-term cost-analysis, long-term cost analysis, and sustainability of the intervention.

Two well-accepted biomarkers of HF disease severity and prognosis, NT-proBNP and galectin-3, and increased biomarkers in older HF patients Tumor necrosis factor alpha, C-reactive protein, and interleukin-6.