Stasis dermatitis: A skin manifestation of poor prognosis in patients with heart failure

Abstract

Background: The relationship between stasis dermatitis (SD), clinical factors, and heart failure (HF) outcomes in outpatients has not been previously assessed.

Methods: This observational cross-sectional study evaluated 324 patients admitted to the HF outpatient clinic. A total of 158 HF outpatients (100 males and 58 females) were enrolled in the study and were divided into two groups depending on whether they were diagnosed with SD within six months before attending the outpatient clinic. Forty-one patients (26 %) diagnosed with SD in the preceding six months were designated group 1, and 117 (74 %) not diagnosed were designated group 2.

Results: Diabetes mellitus (DM) (OR =5.473, p <0.001), chronic obstructive pulmonary disease (COPD) (OR =2.623, p =0.039), and increased systolic pulmonary artery pressure (SPAP) (OR =1.061, p =0.001) values were independently associated with SD in multivariate logistic regression analysis. During the follow-up of 12 ± 4 months, no significant difference was documented between group 1 and group 2 regarding the death ratio (17 % vs. 19 %, p =0.991). In the multivariate Cox proportional-hazards model with a stepwise forward method, the presence of SD diagnosis [hazard ratio (HR) =2.933, 95 % Confidence Interval (CI): 1.660-5.181, p <0.001] and coronary artery disease (CAD) (HR=2.492, 95%CI: 1.238-5.018, p= 0.011) remained independently associated with the risk of HF-related hospitalization.

Conclusion: SD was found, for the first time, to be independently associated with DM, COPD, and increased SPAP values and determined as an independent predictor for HF-related hospitalization.HIPPOKRATIA 2022, 26 (1):13-18.

Keywords: Chronic obstructive pulmonary disease; diabetes mellitus; heart failure; hospitalization; stasis dermatitis; systolic pulmonary artery pressure.