{"doi":"10.1093/ageing/afae152","title":"Postdischarge functional outcomes in older patients with acute heart failure in Japan: the Longevity Improvement &amp; Fair Evidence study","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>Background</jats:title>\n                  <jats:p>The association between care needs level (CNL) at hospitalisation and postdischarge outcomes in older patients with acute heart failure (aHF) has been insufficiently investigated.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>This population-based cohort study was conducted using health insurance claims and CNL data of the Longevity Improvement &amp; Fair Evidence study. Patients aged ≥65 years, discharged after hospitalisation for aHF between April 2014 and March 2022, were identified. CNLs at hospitalisation were classified as no care needs (NCN), support level (SL) and CNL1, CNL2–3 and CNL4–5 based on total estimated daily care time as defined by national standard criteria, and varied on an ordinal scale between SL&amp;CNL1 (low level) to CNL4–5 (fully dependent). The primary outcomes were changes in CNL and death 1 year after discharge, assessed by CNL at hospitalisation using Cox proportional hazard models.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>Of the 17 724 patients included, 7540 (42.5%), 4818 (27.2%), 3267 (18.4%) and 2099 (11.8%) had NCN, SL&amp;CNL1, CNL2–3 and CNL4–5, respectively, at hospitalisation. One year after discharge, 4808 (27.1%), 3243 (18.3%), 2968 (16.7%), 2505 (14.1%) and 4200 (23.7%) patients had NCN, SL&amp;CNL1, CNL2–3, CNL4–5 and death, respectively. Almost all patients’ CNLs worsened after discharge. Compared to patients with NCN at hospitalisation, patients with SL&amp;CNL1, CNL2–3 and CNL4–5 had an increased risk of all-cause death 1 year after discharge (hazard ratio [95% confidence interval]: 1.19 [1.09–1.31], 1.88 [1.71–2.06] and 2.56 [2.31–2.84], respectively).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>Older patients with aHF and high CNL at hospitalisation had a high risk of all-cause mortality in the year following discharge.</jats:p>\n               </jats:sec>","journal":"Age and Ageing","year":2024,"id":655678,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1584016,"name":"Tetsuhisa Kitamura","orcid":"0000-0003-0107-0580","position":1,"is_corresponding":false},{"id":1711611,"name":"Atsushi Hirayama","orcid":null,"position":2,"is_corresponding":false},{"id":1619145,"name":"Yoshimitsu Shimomura","orcid":null,"position":3,"is_corresponding":false},{"id":1619143,"name":"Ling Zha","orcid":null,"position":4,"is_corresponding":false},{"id":1619147,"name":"Masayo Komatsu","orcid":null,"position":5,"is_corresponding":false},{"id":642978,"name":"Sho Komukai","orcid":"0000-0002-4329-2520","position":6,"is_corresponding":false},{"id":1711612,"name":"Yohei Sotomi","orcid":null,"position":7,"is_corresponding":false},{"id":1711613,"name":"Katsuki Okada","orcid":null,"position":8,"is_corresponding":false},{"id":1306465,"name":"Yasushi Sakata","orcid":"0000-0002-5618-4721","position":9,"is_corresponding":false},{"id":1127173,"name":"Fumiko Murata","orcid":"0000-0002-8751-3401","position":10,"is_corresponding":false},{"id":1127174,"name":"Megumi Maeda","orcid":"0000-0002-7252-9945","position":11,"is_corresponding":false},{"id":1584008,"name":"Kosuke Kiyohara","orcid":null,"position":12,"is_corresponding":false},{"id":1711614,"name":"Tomotaka Sobue","orcid":null,"position":13,"is_corresponding":false},{"id":1127175,"name":"Haruhisa Fukuda","orcid":"0000-0003-1120-1548","position":14,"is_corresponding":false},{"id":1619144,"name":"Nobuhiro Narii","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Postdischarge functional outcomes in older patients with acute heart failure in Japan: the Longevity Improvement &amp; Fair Evidence study","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>Background</jats:title>\n                  <jats:p>The association between care needs level (CNL) at hospitalisation and postdischarge outcomes in older patients with acute heart failure (aHF) has been insufficiently investigated.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>This population-based cohort study was conducted using health insurance claims and CNL data of the Longevity Improvement &amp; Fair Evidence study. Patients aged ≥65 years, discharged after hospitalisation for aHF between April 2014 and March 2022, were identified. CNLs at hospitalisation were classified as no care needs (NCN), support level (SL) and CNL1, CNL2–3 and CNL4–5 based on total estimated daily care time as defined by national standard criteria, and varied on an ordinal scale between SL&amp;CNL1 (low level) to CNL4–5 (fully dependent). The primary outcomes were changes in CNL and death 1 year after discharge, assessed by CNL at hospitalisation using Cox proportional hazard models.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>Of the 17 724 patients included, 7540 (42.5%), 4818 (27.2%), 3267 (18.4%) and 2099 (11.8%) had NCN, SL&amp;CNL1, CNL2–3 and CNL4–5, respectively, at hospitalisation. One year after discharge, 4808 (27.1%), 3243 (18.3%), 2968 (16.7%), 2505 (14.1%) and 4200 (23.7%) patients had NCN, SL&amp;CNL1, CNL2–3, CNL4–5 and death, respectively. Almost all patients’ CNLs worsened after discharge. Compared to patients with NCN at hospitalisation, patients with SL&amp;CNL1, CNL2–3 and CNL4–5 had an increased risk of all-cause death 1 year after discharge (hazard ratio [95% confidence interval]: 1.19 [1.09–1.31], 1.88 [1.71–2.06] and 2.56 [2.31–2.84], respectively).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>Older patients with aHF and high CNL at hospitalisation had a high risk of all-cause mortality in the year following discharge.</jats:p>\n               </jats:sec>","is_dataset_classified":null,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39023236","pmcid":null,"openalex_id":"https://openalex.org/W4400780063","authors":[],"funders":[{"funder_name":"Osaka University Graduate School of Medicine","grant_id":"1-3","title":null},{"funder_name":"Osaka University Graduate School of Medicine","grant_id":"OUMP 3-1","title":null},{"funder_name":"JST FOREST Programme","grant_id":"JPMJFR205J","title":null},{"funder_name":"Japan Society for the Promotion of Science","grant_id":"JP20H00563","title":null}],"total_grants":4,"fwci":0.8807,"citation_percentile":0.76462646,"influential_citations":0,"citation_trend":[{"year":2025,"count":1},{"year":2026,"count":2}],"oa_status":"bronze","license":"https://academic.oup.com/pages/standard-publication-reuse-rights","oa_locations":[{"url":"https://academic.oup.com/ageing/article-pdf/53/7/afae152/58585251/afae152.pdf","host_type":"journal"},{"url":"https://academic.oup.com/ageing/article-pdf/53/7/afae152/58585251/afae152.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1093/ageing/afae152","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39023236","host_type":"repository"}],"fields_of_study":["Heart Failure Treatment and Management","Chronic Disease Management Strategies","Frailty in Older Adults"],"mesh_terms":["Acute Disease","Aged","Aged, 80 and over","Female","Heart Failure","Hospitalization","Humans","Japan","Longevity","Male","Patient Discharge"],"keywords":["Medicine","Hazard ratio","Heart failure","Confidence interval","Proportional hazards model","Internal medicine","Cohort","Cohort study","Acute care","Emergency medicine","Health care","Discharge","Patients","Older People","Acute Heart Failure","Hospitalisations","Care Needs Level"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-11T18:32:56.743347Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}