Most elderly patients hospitalized for heart failure lack the abilities needed to perform the tasks required for self‐care: Impact on outcomes

Abstract

Aim To evaluate the abilities to perform essential tasks for heart failure (HF) self‐management in elderly patients, and its influence on post‐discharge prognosis.

Methods and results Overall, 415 patients ≥70 years old hospitalized for HF were included and followed during 1 year. The ability to perform six specific tasks (use of a scale, weight registration, diuretic identification, knowledge of salted foods, oedema identification, and treatment adjustment) was tested and distributed on terciles (T) of performance. Correlation with the self‐administered questionnaire European HF Self‐care Behaviour Scale (EHFScBS) was evaluated. The independent influence of self‐care on 1‐year mortality and readmission risks was calculated by Cox proportional hazards regression analysis. Mean age was 80.1 years. On average, patients could perform 2.9 ± 1.6 of self‐care tasks, and only 5.3% could perform the six tasks correctly. Patients with previous HF self‐care education had slight better performance (3.2 ± 1.6 vs 2.8 ± 1.6, P < 0.02). A weak correlation was found between EHFScBS and number of tasks correctly performed (r = −0.135; P = 0.006). One‐year mortality in T1, T2, and T3 patients was 33.0%, 20.7%, and 14.1%, respectively (P = 0.002). Multivariable analysis showed T2 and T3 groups having a lower adjusted mortality risk compared with T1 [hazard ratio (HR) 0.58; 95% confidence interval (CI) 0.32–1.03; and HR 0.40; 95% CI 0.21–0.77, respectively], without differences in readmissions.

Conclusion Most elderly patients admitted for HF are unable to perform several essential tasks needed for HF self‐care. Self‐perception of care was poorly correlated with real ability, and poor self‐care ability was associated with higher 1‐year mortality risk.