What is the clinical evidence from this study?

Study design: Cohort. Population: Decompensated heart failure (n=299). Intervention: Worsening renal function (WRF) vs. No worsening renal function. Primary outcome: Length of stay (days) (p=0.006).

What does this research mean for the field?

Worsening renal function occurs in 29% of patients hospitalized with decompensated heart failure and is associated with a longer median length of stay, but not with increased mortality or re-hospitalization rates when major in-hospital complications are excluded. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine the prevalence, clinical risk factors, and prognostic impact of worsening renal function on mortality and re-hospitalization in patients admitted with decompensated heart failure.

April 19, 2006European Heart JournalOpen Access

Prevalence and impact of worsening renal function in patients hospitalized with decompensated heart failure: results of the prospective outcomes study in heart failure (POSH)

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Key result

Worsening renal function occurred in 29% of patients hospitalized with decompensated heart failure and was associated with a longer median length of stay (11 vs. 9 days, P=0.006).

Key Points

To determine the prevalence, clinical risk factors, and prognostic impact of worsening renal function on mortality and re-hospitalization in patients admitted with decompensated heart failure.
Prospective multicenter cohort of 299 patients (mean age 68 years, 74% men) with decompensated heart failure and left ventricular ejection fraction ≤40% enrolled across eight European countries.
Defined worsening renal function (WRF) as an increase in serum creatinine >26 µmol/L (~0.3 mg/dL) from baseline admission levels, with 95% complete follow-up at 6 months.
In-hospital WRF occurred in 29% of patients (72/248; 95% CI, 26%–32%) and was independently associated with baseline serum creatinine (OR 3.02; 95% CI, 1.58–5.76), pulmonary edema (OR 3.35; 95% CI, 1.79–6.27), and history of atrial fibrillation (OR 0.35; 95% CI, 0.18–0.67).
Patients who developed WRF had significantly longer hospital stays (median 11 days vs. 9 days, P=0.006), but experienced no statistically significant increase in 6-month mortality or re-hospitalization rates.

Study Design

Type

Cohort (n=299)

Multicenter

Yes

Structured PICO

Population

299 patients hospitalized for decompensated heart failure with a history of ejection fraction <=40%, mean age 68, 74% men, across eight European countries.

Outcome

Prevalence and risk factors for worsening renal function (increase in serum creatinine >26 micromol/L from admission), and association with subsequent re-hospitalization and mortality at 6 monthshard clinical

Main Result

Absolute Event Rate: 11% vs 9%

p-value: p=0.006

Worsening renal function is common in patients hospitalized with decompensated HFrEF and prolongs hospital stay, but may not independently increase 6-month mortality or re-hospitalization when major in-hospital complications are excluded.

Discussion

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Implication

Worsening renal function may prolong stay in decompensated HF; leaves open independent effects on mortality or readmission.

Cite This Study

Cowie et al. (2006) conducted a cohort in Decompensated heart failure (n=299). Worsening renal function (WRF) vs. No worsening renal function was evaluated on Length of stay (days) (p=0.006). Worsening renal function occurred in 29% of patients hospitalized with decompensated heart failure and was associated with a longer median length of stay (11 vs. 9 days, P=0.006).

synapsesocial.com/papers/6a1c348bbc71fb1015a953be https://doi.org/10.1093/eurheartj/ehi859

Topics

Heart failure HFrEF treatment Heart failure hospitalization

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Prevalence and impact of worsening renal function in patients hospitalized with decompensated heart failure: results of the prospective outcomes study in heart failure (POSH)

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Topics

Prevalence and impact of worsening renal function in patients hospitalized with decompensated heart failure: results of the prospective outcomes study in heart failure (POSH)

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider