Change in plasma volume and prognosis in acute decompensated heart failure: an observational cohort study-Reference-Cited by-同舟云学术

Change in plasma volume and prognosis in acute decompensated heart failure: an observational cohort study

Published:2016-09 Issue:9 Volume:109 Page:337-346
ISSN:0141-0768
Container-title:Journal of the Royal Society of Medicine
language:en
Short-container-title:J R Soc Med

Author:

Hudson Sarah R¹²,Chan Daniel¹²,Ng Leong L¹²

Affiliation:

1. Department of Cardiovascular Sciences, University of Leicester, Leicester LE3 9QP, UK

2. NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK

Abstract

Objectives This study aimed to develop an inexpensive, readily available prognostic indicator in acute decompensated heart failure patients to guide management and improve outcome. Prognostic biomarkers for heart failure exist but are expensive and not routinely performed. Increasing plasma volume has been associated with worse outcomes. Setting UK University Teaching Hospital. Design Observational Cohort study. Participants 967 patients with acute decompensated heart failure. Methods Haemoglobin and haematocrit were measured at admission and discharge and were used to calculate the plasma volume change using the Strauss-Davis-Rosenbaum formula. Main outcome measures Endpoints were death and the composite of death and/or heart failure hospitalisation. Change in plasma volume was added to ADHERE scoring to determine predictive value. Results During follow-up, 536 died and 626 died or were hospitalised with heart failure. Multivariable Cox models showed change in plasma volume was an independent predictor of mortality (hazard ratio (HR) [95% confidence interval (CI)]: 1.150 [1.031–1.283], p = 0.012) and death or heart failure hospitalisation (HR: 1.138 [1.029–1.259], p = 0.012). Kaplan–Meier analysis of change in plasma volume tertiles for outcome measures showed significant difference for the top tertile compared to the lower two. Multivariable analysis of change in plasma volume with ADHERE scoring showed change in plasma volume change remained an independent predictor of death (HR: 1.138 [1.026–1.261], p = 0.015) and death or heart failure hospitalisation (HR: 1.129 [1.025–1.243], p = 0.014). Conclusions Change in plasma volume over an admission can be used for prognostication and adds value to the ADHERE score. Change in plasma volume can be easily and inexpensively calculated from routine blood tests. Clinically, this may facilitate targeted treatment of acute decompensated heart failure patients at greatest risk.

Publisher

SAGE Publications

Subject

General Medicine

Link

http://journals.sagepub.com/doi/pdf/10.1177/0141076816661316

Reference25 articles.

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