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Impact of Exercise Programs on Hospital Readmission Following Hospitalization for Heart Failure: A Systematic Review

  • Elderly and Heart Disease (K. Dharmarajan, Section Editor)
  • Published:
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Abstract

Given persistently high 30-day readmission rates among patients hospitalized for heart failure, there is an ongoing need to identify new interventions to reduce readmissions. Although exercise programs can improve outcomes among ambulatory heart failure patients, it is not clear whether this benefit extends to reducing readmissions following heart failure hospitalization. We therefore conducted a systematic review of the literature to identify randomized controlled trials examining the impact of exercise programs on hospital readmissions among patients recently hospitalized for heart failure. We searched Ovid MEDLINE, EMBASE, and the Wiley Cochrane Library for studies that fulfilled pre-defined criteria, including that the exercise program pre-specify activity type and exercise frequency, duration, and intensity. Exercise interventions could occur at any location including within the hospital, at an outpatient facility, or at home. Among 1213 unique publications identified, only one study fulfilled inclusion criteria. This study was a single-site randomized controlled trial that consisted of a 12-week exercise program in a cohort of 105 patients with a principal diagnosis of heart failure at a metropolitan hospital in Australia. This study revealed a reduction in 12-month all-cause and cardiovascular-related hospitalization rates. However, inferences were limited by its single-site study design, small sample size, premature termination, and high risk for selection, performance, and detection bias. As no studies have built upon the findings of this study, it remains unknown whether exercise programs can improve readmission rates among patients recently hospitalized for heart failure, a significant gap in the literature.

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Authors and Affiliations

  1. Division of Cardiology, Weill Cornell Medicine, 525 East 68th Street, New York, NY, 10021, USA

    Parag Goyal

  2. Weill Cornell Medicine, 1300 York Avenue, New York, NY, USA

    Diana Delgado

  3. University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, USA

    Scott L. Hummel

  4. Ann Arbor Veterans Affairs Health System, 2215 Fuller Road, Ann Arbor, MI, USA

    Scott L. Hummel

  5. Yale School of Medicine, 333 Cedar Street, New Haven, CT, USA

    Kumar Dharmarajan

  6. Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, 1 Church St, New Haven, CT, USA

    Kumar Dharmarajan

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  1. Parag Goyal
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Correspondence to Parag Goyal.

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Conflict of Interest

Drs Goyal and Delgado declare no conflict of interests.

Dr. Hummel is supported by grant K23-109176 from the National Institute of Health and National Heart, Lung, and Blood Institute.

Dr. Dharmarajan works under contract with the Centers for Medicare and Medicaid Services to develop and maintain performance measures and is a paid consultant and member of a scientific advisory board for Clover Health, Inc. and is also supported by grant K23AG048331 from the National Institute on Aging and the American Federation for Aging Research through the Paul B. Beeson Career Development Award Program and by grant P30AG021342 from the National Institute on Aging via the Yale Claude D. Pepper Older Americans Independence Center.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Goyal, P., Delgado, D., Hummel, S.L. et al. Impact of Exercise Programs on Hospital Readmission Following Hospitalization for Heart Failure: A Systematic Review. Curr Cardiovasc Risk Rep 10, 33 (2016). https://doi.org/10.1007/s12170-016-0514-5

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