Lung ultrasound, inferior vena cava ultrasound, NT-pro-BNP and discharge body weight as predictors of rehospitalization in acute heart failure

Abstract Introduction Patients with acute heart failure exhibit high rates of early rehospitalization accompanied by significant mortality. Therefore, identifying high-risk patients who are prone to disease exacerbation may enable early therapeutic interventions for improved disease management. Objectives To compare lung and inferior vena cava ultrasound findings, N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), and discharge body weight between groups of patients who were readmitted and those who were not within 30 days following hospitalization for acute heart failure. Materials and Methods This single-center, prospective observational study was conducted at a Brazilian hospital. Adult patients hospitalized for acute heart failure were enrolled. On the day of hospital discharge, NT-pro-BNP levels and body weight data were collected, and bedside lung and inferior vena cava ultrasound examinations were performed. The patients were followed up for up to 30 days after discharge. The primary outcome was rehospitalization for acute heart failure. Results A total of 100 patients were included in the final analysis, of whom 10% were readmitted within 30 days owing to acute heart failure. The number of patients with total B-line scores 3 in the readmitted and non-readmitted groups was 6 and 19, respectively (60% and 21%, respectively; absolute risk difference: 39%; p = 0.014). The mean inferior vena cava collapsibility index was significantly lower in readmitted compared to that in non-readmitted patients (25.5% vs 39.8%, standard deviation: 15.4% and 18.4%, respectively; p = 0.020). However, mean body weight and mean NT-pro-BNP levels at discharge did not differ between the groups (71.4 kg vs. 74.0 kg, p = 0.850; 2.550 pg/ml vs. 5.515 pg/ml, p = 0.079). In a multivariate logistic regression model adjusted for sex, age, discharge body weight, and left ventricular ejection fraction, a total B-lines score 3 had an odds ratio of 4.72 (95% confidence interval (CI): 1.01–22.13; p = 0.049), while the inferior vena cava collapsibility index had an odds ratio of 0.96 (95% CI: 0.91–1.01; p = 0.091). Conclusion A total B-line score 3 at discharge in patients hospitalized for acute heart failure was associated with 30-day rehospitalization. In contrast, inferior vena cava ultrasound, discharge body weight, and NT-pro-BNP level at discharge were not significant predictors of rehospitalization.Table 1 Table 2