Key result
Predischarge hydration status linked to ~6% higher acute heart failure readmission risk per 1% increase.
Why the study?
Fluid overload is a hallmark in acute heart failure, and bioelectrical impedance vector analysis has emerged as a noninvasive method to quantify hydration status before discharge, but its association with mortality and rehospitalization risk was not established.
Cohort (n=369)
No
Hazard Ratio: 1.06 (95% CI 1.03–1.1)
Absolute Event Rate: 3.83% vs 2.68%
p-value: p=0.001
May inform discharge risk stratification in acute HF; hypothesis-generating for hydration-targeted interventions in trials.
AIMS: Fluid overload is a hallmark in acute heart failure (AHF). Bioelectrical impedance vector analysis (BIVA) has emerged as a noninvasive method for quantifying patients' hydration. We aimed to evaluate the effect of BIVA hydration status (BHS) measured before discharge on mortality and rehospitalization for AHF. METHODS: We included 369 consecutive patients discharged from the cardiology department from a third-level hospital with a diagnosis of AHF. On the basis of BHS, patients were grouped into three categories: hyper-hydration (>74.3%), normo-hydration (72.7-74.3%) and dehydration (<72.7%). Appropriate survival techniques were used to evaluate the association between BHS and the risk of death and readmission for AHF. RESULTS: At a median follow-up of 12 months (interquartile range, IQR: 5-19), 80 (21.7%) deaths and 93 (25.2%) readmissions for AHF were registered. The mortality and readmission rates for the BHS categories were hyper-hydration (3.28 and 3.83 per 10 persons-years); normo-hydration (1.43 and 2.68 per 10 persons-years); and dehydration (2.24 and 2.53 per 10 persons-years) (P < 0.05 for all comparisons). In an adjusted analysis, BHS displayed a significant association with mortality (P = 0.004), with a higher mortality risk in those with hyperhydration. Likewise, BHS showed to linearly predict AHF-readmission risk [hazard ratio 1.06 (1.03-1.10); P = 0.001 per increase in 1%]. CONCLUSION: In patients admitted with AHF, BHS assessed before discharge was independently associated with the risk of death and AHF-readmission.
No takes yet. Share an insight, caveat, or question.
Núñez et al. (2014) conducted a cohort in Acute heart failure (n=369). BIVA hydration status (BHS) vs. Normo-hydration (72.7-74.3%) was evaluated on AHF-readmission risk (HR 1.06, 95% CI 1.03-1.10, p=0.001). Bioelectrical impedance vector analysis hydration status measured before discharge linearly predicted acute heart failure readmission risk (HR 1.06 per 1% increase) and was independently associated with mortality.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: