TY - JOUR
T1 - Validation of the “Doorbell Test”
T2 - A Novel Functional Test of Frailty and Clinical Status After Acute Decompensated Heart Failure
AU - Gunton, James E.
AU - Nandal, Savvy
AU - Jones, Julieanne
AU - Chew, Derek P.
AU - Marwick, Thomas H.
AU - De Pasquale, Carmine G.
PY - 2020/7
Y1 - 2020/7
N2 - BackgroundAcute
decompensated heart failure (ADHF) carries a high event rate following
discharge. The complex interplay between age, frailty and decongestion
may lend itself to a functional test.MethodsIn
the doorbell test the patient simulates answering the doorbell. They
are timed rising from a recumbent position, bending over twice and
walking 10 metres, this time is added to the change in respiratory rate.We
aimed to determine if the doorbell test was associated with post ADHF
events (death or readmission). The test was performed at hospital
discharge, with follow up at 30-days and 1-year.ResultsIn
74 patients at 30-days there was a 14% event rate. At 1-year there were
40 (54%) events (9 deaths and 31 readmissions, 28 were cardiovascular
of which 14 were [heart failure] HF). Amongst those who had an event at
30-days only doorbell test scores were different (58 [36,72] vs 32
[26,53] p < 0.05). One-year (1-year) events were associated with
doorbell test scores (47 [29,62] vs 30 [26,42] p < 0.05), body weight
(78 kg [68,94] vs 95 [76,105] (p < 0.05), creatinine (134 mmol/L
[114, 173] vs 99 [82, 133] p < 0.01) and age (76 years [61,86] vs 67
[53, 73] p < 0.01). Heart failure readmissions were associated with
doorbell test scores (56 [46,68] vs 30 [26,47] p < 0.001). Death was
associated with body weight (74 kg [69,81] vs 88 [72,101] p < 0.05)
and age (83 years [78,86] vs 69 [55,77] p < 0.01).After
age stratification, the hazard ratio for heart failure readmission
associated with a high doorbell test score was 11.08 (95%C.I. 2.01–61.17
p = 0.006), while the hazard ratio for 1-year cardiovascular
readmission was 4.62 (95%C.I. 1.71–12.51 p = 0.003). There was no
association with 1-year mortality.ConclusionThe
doorbell test represents a novel test of multiple domains of the ADHF
pre-discharge state and demonstrates an association with 30-day and
1-year rehospitalisation.
AB - BackgroundAcute
decompensated heart failure (ADHF) carries a high event rate following
discharge. The complex interplay between age, frailty and decongestion
may lend itself to a functional test.MethodsIn
the doorbell test the patient simulates answering the doorbell. They
are timed rising from a recumbent position, bending over twice and
walking 10 metres, this time is added to the change in respiratory rate.We
aimed to determine if the doorbell test was associated with post ADHF
events (death or readmission). The test was performed at hospital
discharge, with follow up at 30-days and 1-year.ResultsIn
74 patients at 30-days there was a 14% event rate. At 1-year there were
40 (54%) events (9 deaths and 31 readmissions, 28 were cardiovascular
of which 14 were [heart failure] HF). Amongst those who had an event at
30-days only doorbell test scores were different (58 [36,72] vs 32
[26,53] p < 0.05). One-year (1-year) events were associated with
doorbell test scores (47 [29,62] vs 30 [26,42] p < 0.05), body weight
(78 kg [68,94] vs 95 [76,105] (p < 0.05), creatinine (134 mmol/L
[114, 173] vs 99 [82, 133] p < 0.01) and age (76 years [61,86] vs 67
[53, 73] p < 0.01). Heart failure readmissions were associated with
doorbell test scores (56 [46,68] vs 30 [26,47] p < 0.001). Death was
associated with body weight (74 kg [69,81] vs 88 [72,101] p < 0.05)
and age (83 years [78,86] vs 69 [55,77] p < 0.01).After
age stratification, the hazard ratio for heart failure readmission
associated with a high doorbell test score was 11.08 (95%C.I. 2.01–61.17
p = 0.006), while the hazard ratio for 1-year cardiovascular
readmission was 4.62 (95%C.I. 1.71–12.51 p = 0.003). There was no
association with 1-year mortality.ConclusionThe
doorbell test represents a novel test of multiple domains of the ADHF
pre-discharge state and demonstrates an association with 30-day and
1-year rehospitalisation.
KW - Acute Decompensated Heart Failure
KW - Chronic Heart Failure
KW - Functional test
UR - http://www.scopus.com/inward/record.url?scp=85072820677&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1059738
U2 - 10.1016/j.hlc.2019.08.010
DO - 10.1016/j.hlc.2019.08.010
M3 - Article
AN - SCOPUS:85072820677
VL - 29
SP - 1054
EP - 1062
JO - Heart, Lung and Circulation
JF - Heart, Lung and Circulation
SN - 1443-9506
IS - 7
ER -