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.
Digital Object Identifier (DOI)
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).
Howie-Esquivel, Jill; Dracup, Kathleen; Whooley, Mary A.; McCulloch, Charles; Jin, Chengshi; Moser, Debra K.; Clark, Robyn A.; Pelter, Michele M.; Biddle, Martha J.; and Park, Linda G., "Rapid 5 lb Weight Gain Is Not Associated with Readmission in Patients with Heart Failure" (2019). Nursing Faculty Publications. 45.