Hypochloraemia and 30 day readmission rate in patients with acute decompensated heart failure
Abstract Aims Despite recent advances in guideline‐directed therapy, rehospitalization rates for acute decompensated heart failure (ADHF) remain high. Recently published studies demonstrated the emerging role of hypochloraemia as a predictor of poor outcomes in patients with ADHF. This study sought...
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| Format: | Article |
| Language: | English |
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Wiley
2020-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.12587 |
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| author | Roman Marchenko Adam Sigal Thomas E. Wasser Jessica Reyer Jared Green Christopher Mercogliano Muhammad Sohail Khan Anthony A. Donato |
| author_facet | Roman Marchenko Adam Sigal Thomas E. Wasser Jessica Reyer Jared Green Christopher Mercogliano Muhammad Sohail Khan Anthony A. Donato |
| author_sort | Roman Marchenko |
| collection | DOAJ |
| description | Abstract Aims Despite recent advances in guideline‐directed therapy, rehospitalization rates for acute decompensated heart failure (ADHF) remain high. Recently published studies demonstrated the emerging role of hypochloraemia as a predictor of poor outcomes in patients with ADHF. This study sought to determine the correlation between low serum chloride and 30 day hospital readmission in patients with ADHF. Methods and results We retrospectively reviewed electronic medical records of 1504 patients who were admitted to one 700 bed US tertiary care centre with the diagnosis of ADHF between June 2013 and December 2014. Of the 1504 reviewed records, 1241 were selected for further analysis. Hypochloraemia (either on admission or at discharge) was identified in 289 patients (23.3%) and was associated with significantly higher 30 day hospital readmission rate or death (42.2% vs. 33.7%, P = 0.008). This association persisted in multivariate analysis when controlling for serum sodium, weight loss, diuretic dose, adjunct thiazide use, serum blood urea nitrogen, and BNP levels (OR: 1.35, 95% CI: 1.02–1.77, P = 0.033); however, the predictive value of the overall model was low (Naglkerke R2 = 0.040). Hypochloraemia was also found to be associated with increased 12 month mortality in our cohort (31.4% vs. 20.2%, P = 0.015) that correlates with the results of previously published studies. Conclusions Low serum chloride measured in patients admitted for ADHF is independently but weakly associated with increased 30 day readmission rate and demonstrated low predictive value as a potential biomarker in this cohort. |
| format | Article |
| id | doaj-art-6ad3ddce18f44c688cdc1a8ebdaa1878 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-6ad3ddce18f44c688cdc1a8ebdaa18782025-02-03T10:25:46ZengWileyESC Heart Failure2055-58222020-06-017390390710.1002/ehf2.12587Hypochloraemia and 30 day readmission rate in patients with acute decompensated heart failureRoman Marchenko0Adam Sigal1Thomas E. Wasser2Jessica Reyer3Jared Green4Christopher Mercogliano5Muhammad Sohail Khan6Anthony A. Donato7Reading Hospital Tower Health Medical Group West Reading PA USAReading Hospital Tower Health Medical Group West Reading PA USAReading Hospital Tower Health Medical Group West Reading PA USAReading Hospital Tower Health Medical Group West Reading PA USAReading Hospital Tower Health Medical Group West Reading PA USAReading Hospital Tower Health Medical Group West Reading PA USAReading Hospital Tower Health Medical Group West Reading PA USAReading Hospital Tower Health Medical Group West Reading PA USAAbstract Aims Despite recent advances in guideline‐directed therapy, rehospitalization rates for acute decompensated heart failure (ADHF) remain high. Recently published studies demonstrated the emerging role of hypochloraemia as a predictor of poor outcomes in patients with ADHF. This study sought to determine the correlation between low serum chloride and 30 day hospital readmission in patients with ADHF. Methods and results We retrospectively reviewed electronic medical records of 1504 patients who were admitted to one 700 bed US tertiary care centre with the diagnosis of ADHF between June 2013 and December 2014. Of the 1504 reviewed records, 1241 were selected for further analysis. Hypochloraemia (either on admission or at discharge) was identified in 289 patients (23.3%) and was associated with significantly higher 30 day hospital readmission rate or death (42.2% vs. 33.7%, P = 0.008). This association persisted in multivariate analysis when controlling for serum sodium, weight loss, diuretic dose, adjunct thiazide use, serum blood urea nitrogen, and BNP levels (OR: 1.35, 95% CI: 1.02–1.77, P = 0.033); however, the predictive value of the overall model was low (Naglkerke R2 = 0.040). Hypochloraemia was also found to be associated with increased 12 month mortality in our cohort (31.4% vs. 20.2%, P = 0.015) that correlates with the results of previously published studies. Conclusions Low serum chloride measured in patients admitted for ADHF is independently but weakly associated with increased 30 day readmission rate and demonstrated low predictive value as a potential biomarker in this cohort.https://doi.org/10.1002/ehf2.12587Acute decompensated heart failureChlorideReadmission |
| spellingShingle | Roman Marchenko Adam Sigal Thomas E. Wasser Jessica Reyer Jared Green Christopher Mercogliano Muhammad Sohail Khan Anthony A. Donato Hypochloraemia and 30 day readmission rate in patients with acute decompensated heart failure ESC Heart Failure Acute decompensated heart failure Chloride Readmission |
| title | Hypochloraemia and 30 day readmission rate in patients with acute decompensated heart failure |
| title_full | Hypochloraemia and 30 day readmission rate in patients with acute decompensated heart failure |
| title_fullStr | Hypochloraemia and 30 day readmission rate in patients with acute decompensated heart failure |
| title_full_unstemmed | Hypochloraemia and 30 day readmission rate in patients with acute decompensated heart failure |
| title_short | Hypochloraemia and 30 day readmission rate in patients with acute decompensated heart failure |
| title_sort | hypochloraemia and 30 day readmission rate in patients with acute decompensated heart failure |
| topic | Acute decompensated heart failure Chloride Readmission |
| url | https://doi.org/10.1002/ehf2.12587 |
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