Effect of Post-Loop Diuretic Urinary Sodium Level on Length of Stay and Rehospitalization in Acutely Decompensated Heart Failure Patients.

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology Research Pub Date : 2024-10-01 Epub Date: 2024-09-16 DOI:10.14740/cr1696
Rarsari Soerarso, Dian Yaniarti Hasanah, Emir Yonas, Fikri Muhamad Yamin Tawari, Sunu Budhi Raharjo, Bambang Budi Siswanto, Maarten J Cramer, Pim van der Harst, Marish I F J Oerlemans
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Abstract

Background: In Indonesia, heart failure has become a major community problem because of the high cost of care, low quality of life, and premature death. Until now, loop diuretics are still the main therapy in patients with acute decompensated heart failure with clinical congestion. Diuretic responsiveness can be assessed objectively by measuring sodium urine. This study aimed to determine the response of natriuresis 2 h after loop diuretic administration and its relationship to length of stay and readmission within 30 days in daily clinical practice.

Methods: This is a prospective cohort study conducted at the National Cardiovascular Center Harapan Kita Hospital in acute decompensated heart failure patients. Patient characteristics were collected from medical records. Response to intravenous (IV) loop diuretics was assessed using urinary sodium laboratory panels. The primary outcomes of interest in this study were length of stay and rehospitalization. Analyses were conducted between the outcome of interests and patient characteristics.

Results: There were 51 acute decompensated heart failure patients in this study with 78.4% males. The mean age was 52.47 ± 13.62. The mean ejection fraction was 37.53±17.95%, with the majority of patients having a left ventricular ejection fraction less than 40% (62.7% of study subjects). The average glomerular filtration rate of subjects in this study was 57.29 ± 27.25 mL/min. Pearson correlation test between pre- and post-loop diuretic urinary sodium showed trends of significant correlation (r = -0.238, P = 0.093) and (r = -0.308, P = 0.028), respectively. Patients with lower pre-loop diuretic urinary sodium were shown to have a shorter length of stay (8.57 ± 6.161 vs. 5.30 ± 4.01, P = 0.04), while patients with lower post-loop diuretic urinary sodium showed trends of longer length of stay (8.67 ± 4.14 vs. 6.03 ± 5.39, P = 0.126).

Conclusions: In this study, we observe lower rehospitalization in patients with higher pre-loop diuretic urinary sodium levels. Post-loop diuretic urinary sodium level was shown to be inversely related to length of stay in acute decompensated heart failure patients.

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循环利尿后尿钠水平对急性失代偿期心力衰竭患者住院时间和再住院率的影响
背景:在印度尼西亚,心力衰竭已成为一个主要的社区问题,因为其治疗成本高、生活质量低、过早死亡。迄今为止,襻利尿剂仍是临床充血的急性失代偿性心力衰竭患者的主要治疗方法。通过测量尿钠可客观评估利尿剂的反应性。本研究旨在确定襻利尿剂用药 2 小时后的尿钠反应及其与日常临床实践中住院时间和 30 天内再入院的关系:这是一项前瞻性队列研究,在国家心血管中心北原医院进行,对象是急性失代偿性心力衰竭患者。从病历中收集患者特征。通过尿钠化验单评估患者对静脉注射环利尿剂的反应。本研究的主要结果是住院时间和再次住院时间。对相关结果和患者特征进行了分析:本研究共有 51 名急性失代偿性心力衰竭患者,其中 78.4% 为男性。平均年龄为(52.47±13.62)岁。平均射血分数为(37.53±17.95)%,大多数患者的左心室射血分数低于 40%(占研究对象的 62.7%)。研究对象的平均肾小球滤过率为(57.29±27.25)毫升/分钟。循环前和循环后利尿剂尿钠之间的皮尔逊相关性检验分别显示出显著的相关趋势(r = -0.238,P = 0.093)和(r = -0.308,P = 0.028)。循环前利尿剂尿钠较低的患者住院时间较短(8.57 ± 6.161 vs. 5.30 ± 4.01,P = 0.04),而循环后利尿剂尿钠较低的患者住院时间呈延长趋势(8.67 ± 4.14 vs. 6.03 ± 5.39,P = 0.126):在本研究中,我们观察到循环利尿前尿钠水平较高的患者再住院率较低。循环利尿后的尿钠水平与急性失代偿性心力衰竭患者的住院时间成反比。
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来源期刊
Cardiology Research
Cardiology Research CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.50
自引率
0.00%
发文量
42
期刊介绍: Cardiology Research is an open access, peer-reviewed, international journal. All submissions relating to basic research and clinical practice of cardiology and cardiovascular medicine are in this journal''s scope. This journal focuses on publishing original research and observations in all cardiovascular medicine aspects. Manuscript types include original article, review, case report, short communication, book review, letter to the editor.
期刊最新文献
Advances in the Understanding and Treatment of Chronic Chagas Cardiomyopathy. Detection of Left Atrial Remodeling by Three-Dimensional Echocardiography in Symptomatic Patients Known to Had Non-Obstructive Hypertrophic Cardiomyopathy. Diverse Concepts in Definitions of Dilated Cardiomyopathy: Theory and Practice. Effect of Post-Loop Diuretic Urinary Sodium Level on Length of Stay and Rehospitalization in Acutely Decompensated Heart Failure Patients. Evaluating the Prognostic Value of the Modified H2FPEF Score in Patients With Heart Failure With Preserved Ejection Fraction.
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