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

Cowie, M.R., Komajda, M., Murray-Thomas, T., Underwood, J. ORCID: https://orcid.org/0000-0001-6963-2821 and Ticho, B. 2006. Prevalence and impact of worsening renal function in patients hospitalized with decompensated heart failure: Results of the prospective outcomes study in heart failure (POSH). European Heart Journal 27 (10) , pp. 1216-1222. 10.1093/eurheartj/ehi859

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Abstract

Aims To determine the prevalence and risk factors for worsening renal function (WRF) among patients hospitalized for decompensated heart failure (HF) and the association with subsequent re-hospitalization and mortality. Methods and results We prospectively enrolled 299 patients across eight European countries (mean age 68, 74% men). HF was defined using the European Society of Cardiology criteria, but only patients with a history of ejection fraction ≤40% on echocardiography were recruited. WRF was defined as an increase in serum creatinine >26 µmol/L (≈0.3 mg/dL) from admission. Follow-up was 95% complete to 6 months. Nearly one-third of patients [72 of 248 patients, 29% (95% CI 26–32%)] developed WRF during hospitalization, excluding patients who had a major in-hospital complication likely to compromise renal function. The risk of WRF in this group was independently associated with serum creatinine levels on admission [odds ratio (OR) 3.02 (95% CI 1.58–5.76)], pulmonary oedema [OR 3.35 (1.79–6.27)], and a history of atrial fibrillation [OR 0.35 (0.18–0.67)]. Although the mortality of WRF patients was not increased significantly, the length of stay was 2 days longer [median 11 days (90% range (4–41) vs. 9 days (4–34), P=0.006]. The re-hospitalization rate was similar in both groups. Conclusion WRF is common in patients admitted to European hospitals with decompensated HF. Such patients have longer duration admissions, but a similar mortality and re-hospitalization rate to those without WRF (if patients experiencing a major in-hospital complication are excluded)

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Oxford University Press (OUP): Policy B
ISSN:	0195-668X
Date of Acceptance:	17 March 2006
Last Modified:	26 Oct 2022 07:26
URI:	https://orca.cardiff.ac.uk/id/eprint/124846

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