Short-term weight gain can signal worsening outcomes for heart failure patients, a new study shows. Patients who gain as little as two pounds over the course of a few weeks may require hospitalization within the month, say heart researchers. Heart failure patients who gain more than 10 pounds are eight times more likely than heart failure patients with stable weights to need hospitalization.
Heart failure occurs when the heart cannot pump enough blood to meet the body's needs. Heart defects, certain viral infections, high blood pressure, scarring from previous heart attacks and coronary artery disease can all lead to heart failure. Weight gain may occur due to fluid buildup resulting from heart failure.
The study, published in Circulation, suggests that patients and their doctors may have several days or even weeks to control weight gain and avoid hospitalizations.
The Yale University research team analyzed weight data and hospitalization records from 268 heart failure patients who were weighing themselves daily as part of a disease management program. The average age of the patients was 74. The researchers compared the data from half of the patients who were hospitalized with the half who were not.
The analysis showed that the hospitalized patients had gained more weight than their peers in the month before hospitalization. In the week before hospitalization, weight increased rapidly.
Doctors have known for some time that weight increase may be a sign of worsening heart failure, but the impact of the timing and amount of weight gain on hospitalization has not been studied before, the researchers said.
"We found that even small amounts of weight gain-as small as just over two pounds-predict hospitalization," said lead author Sarwat Chaudhry, MD, assistant professor of medicine at Yale University School of Medicine in New Haven, Connecticut. "We found that weight gain starts well before hospitalization, giving doctors and patients at least a few days to take steps to avoid the need for hospitalization."
People who gained an average of two to five pounds in the week before hospitalization were nearly three times more likely to need hospitalization than heart failure patients with stable weight. Those who gained five to 10 pounds were four and a half times more likely to need hospitalization, and those who gained more than 10 pounds were almost eight times more likely to require hospitalization for heart failure.
"Heart failure is the most common reason for hospitalization among Americans, and more Medicare dollars are spent for heart failure than for any other diagnosis," Dr. Chaudhry said. "Our data suggest that a simple bathroom scale could empower patients in managing their own disease and alert their physicians to early signs of heart failure decompensation (the failure of the heart to maintain adequate blood circulation). Ultimately, our data may help change the standard of care to prevent patients from being hospitalized, improve their quality of life and save precious health care resources."
The researchers noted that not all hospitalizations for heart failure occur after weight gain, but that monitoring weight daily can help patients with heart failure. The team is currently conducting a clinical trial to test whether daily weight measurement can help reduce rates of hospitalization for heart failure patients.