Convergent and Predictive Validity of the 1-Minute Sit-to-Stand Test in Patients With Acute Decompensated Heart...

To evaluate the convergent validity and prognostic validity of the 1-minute sit-to-stand test (1-min STST) as a practical functional assessment tool in patients hospitalized with acute decompensated heart failure (ADHF) during the early postdischarge period.

Prospective cohort study SETTING: West China Hospital of Sichuan University.

A total of 153 patients hospitalized with ADHF.

At hospital discharge, participants underwent assessment with the 1-min STST, Short Physical Performance Battery (SPPB), and 6-minute walk test (6MWT). All patients were followed for 180 days after discharge.

The primary outcome was a 180-day composite endpoint of all-cause mortality or HF-related readmission. Pearson correlation was used to examine associations between 1-min STST repetitions, SPPB score, and 6-minute walk distance. Receiver operating characteristic analysis assessed their ability to predict 180-day composite events (rehospitalization or death), with optimal cutoffs from the Youden Index and area under the curve values (AUCs) compared by DeLong's test. Receiver operating characteristic thresholds were used in Kaplan-Meier analyses (log-rank test), and Cox models estimated adjusted hazard ratios. Statistical significance was set at P≤.05.

A total of 153 patients completed the 1-min STST, SPPB, and 6MWT, with mean values of 19.9 repetitions, 10.3 points, and 356.4 m, respectively. The 1-min STST demonstrated strong convergent validity with 6-minute walk distance (r=.727; P<.001). The 1-min STST showed good predictive performance for the 180-day composite endpoint (AUC=0.786), comparable to 6MWT (AUC=0.708). Patients achieving ≥16 repetitions had significantly higher cumulative survival and better functional capacity.

The 1-min STST is a field exercise test that strongly correlates with the 6MWT and provides prognostic insight in patients with ADHF. A threshold of ≥16 repetitions identifies patients with better survival/less hospitalizations, supporting its utility in clinical risk stratification.