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. 2024 Mar;56(3):1083-1091.
doi: 10.1007/s11255-023-03747-2. Epub 2023 Aug 24.

Early repeat hospitalization for fluid overload in individuals with cardiovascular disease and risks: a retrospective cohort study

Cynthia C Lim  1 , Dorothy Huang  2 , Zhihua Huang  2   3 , Li Choo Ng  2   3 , Ngiap Chuan Tan  4 , Wei Yi Tay  5 , Yong Mong Bee  6 , Andrew Ang  4 , Chieh Suai Tan  2
Affiliations

Early repeat hospitalization for fluid overload in individuals with cardiovascular disease and risks: a retrospective cohort study

Cynthia C Lim et al. Int Urol Nephrol. 2024 Mar.

Abstract

Aims: Fluid overload is a common manifestation of cardiovascular and kidney disease and a leading cause of hospitalizations. To identify patients at risk of recurrent severe fluid overload, we evaluated the incidence and risk factors associated with early repeat hospitalization for fluid overload among individuals with cardiovascular disease and risks.

Methods: Single-center retrospective cohort study of 3423 consecutive adults with an index hospitalization for fluid overload between January 2015 and December 2017 and had cardiovascular risks (older age, diabetes mellitus, hypertension, dyslipidemia, kidney disease, known cardiovascular disease), but excluded if lost to follow-up or eGFR < 15 ml/min/1.73 m2. The outcome was early repeat hospitalization for fluid overload within 30 days of discharge.

Results: The mean age was 73.9 ± 11.6 years and eGFR was 54.1 ± 24.6 ml/min/1.73 m2 at index hospitalization. Early repeat hospitalization for fluid overload occurred in 291 patients (8.5%). After adjusting for demographics, comorbidities, clinical parameters during index hospitalization and medications at discharge, cardiovascular disease (adjusted odds ratio, OR 1.66, 95% CI 1.27-2.17), prior hospitalization for fluid overload within 3 months (OR 2.52, 95% CI 1.17-5.44), prior hospitalization for any cause in within 6 months (OR 1.33, 95% CI 1.02-1.73) and intravenous furosemide use (OR 1.58, 95% CI 1.10-2.28) were associated with early repeat hospitalization for fluid overload. Higher systolic BP on admission (OR 0.992, 95% 0.986-0.998) and diuretic at discharge (OR 0.50, 95% CI 0.26-0.98) reduced early hospitalization for fluid overload.

Conclusion: Patients at-risk of early repeat hospitalization for fluid overload may be identified using these risk factors for targeted interventions.

Keywords: Cardiovascular diseases; Diuretics; Fluid overload; Furosemide; Heart failure; Hospitalization; Kidney disease; Readmission.

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References

    1. Mayne KJ, Shemilt R, Keane DF, Lees JS, Mark PB, Herrington WG (2022) Bioimpedance indices of fluid overload and cardiorenal outcomes in heart failure and chronic kidney disease: a systematic review. J Card Fail 28(11):1628–1641 - DOI - PubMed
    1. Zoccali C, Mallamaci F (2018) Mapping progress in reducing cardiovascular risk with kidney disease: managing volume overload. Clin J Am Soc Nephrol 13(9):1432 - DOI - PubMed - PMC
    1. Koratala A, Ronco C, Kazory A (2022) Diagnosis of fluid overload: from conventional to contemporary concepts. Cardiorenal Med 12(4):141–154 - DOI - PubMed
    1. Blecker S, Ladapo JA, Doran KM, Goldfeld KS, Katz S (2014) Emergency department visits for heart failure and subsequent hospitalization or observation unit admission. Am Heart J 168(6):901-908.e901 - DOI - PubMed - PMC
    1. Ronksley PE, Tonelli M, Manns BJ et al (2017) Emergency department use among patients with CKD: a population-based analysis. Clin J Am Soc Nephrol 12(2):304 - DOI - PubMed - PMC

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