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Hematocrit change as a predictor of readmission for decompensated heart failure: A retrospective single centre study

In patients with acute heart failure (AHF), hemoconcentration has been suggested as a surrogate for volume changes (AHF). However, literatures comparing the outcome of AHF patients that achieved hemoconcentration during hospitalization with those that do not are limited. The aim of this research is...

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Main Authors: Zulastri, Mohd Aizuddin Mohd, Hafidz, Muhammad Imran, Ismail, Muhammad Dzafir, Zuhdi, Ahmad Syadi Mahmood
Format: Article
Published: IMR PRESS 2021
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R Medicine (General)
Online Access:http://eprints.um.edu.my/26469/
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spelling my.um.eprints.264692022-03-07T04:56:57Z http://eprints.um.edu.my/26469/ Hematocrit change as a predictor of readmission for decompensated heart failure: A retrospective single centre study Zulastri, Mohd Aizuddin Mohd Hafidz, Muhammad Imran Ismail, Muhammad Dzafir Zuhdi, Ahmad Syadi Mahmood R Medicine (General) In patients with acute heart failure (AHF), hemoconcentration has been suggested as a surrogate for volume changes (AHF). However, literatures comparing the outcome of AHF patients that achieved hemoconcentration during hospitalization with those that do not are limited. The aim of this research is to see if achieving hemoconcentration prior to discharge is linked to a lower risk of re-admission in AHF patients. 124 patients hospitalized in the Cardiology Unit, University Malaya Medical Centre (UMMC) for AHF between November 2019 and November 2020 were enrolled. Information on patients' clinical characteristics, laboratory values and in-hospital treatments were collected through electronic medical record. At admission and discharge, the change in hematocrit (HCT) levels was calculated, and patients were stratified based on two quantiles of delta HCT, either discharged with hemoconcentration (Delta HCT >1.5%) or without hemoconcentration (Delta HCT <= 1.5%). The study's outcome was AHF readmission after a 90-day follow-up period. Readmission was significantly associated with ejection fraction (p = 0.032) and HCT change (p = 0.005). Consecutively, logistic regression performed revealed that patients with haemoconcentration were 78.3% less likely to be readmitted than those without haemoconcentration (OR = 0.217, p = 0.003, 95% CI = 0.078-0.605) and Patients with a lower ejection fraction have a threefold greater chance of being readmitted than those with a preserved ejection fraction (OR = 3.316, p = 0.022, 95% CI = 1.188-9.256). In conclusion, among patients hospitalized and discharged for AHF, those that (i) do not achieve haemoconcentration and (ii) patients with a reduced ejection fraction were more likely to be readmitted with acute heart failure. Therefore, optimising patients' haematocrit levels prior to discharge may potentially reduce rehospitalizations among heart failure patients. IMR PRESS 2021-06-30 Article PeerReviewed Zulastri, Mohd Aizuddin Mohd and Hafidz, Muhammad Imran and Ismail, Muhammad Dzafir and Zuhdi, Ahmad Syadi Mahmood (2021) Hematocrit change as a predictor of readmission for decompensated heart failure: A retrospective single centre study. Reviews in Cardiovascular Medicine, 22 (2). pp. 505-512. ISSN 1530-6550, DOI https://doi.org/10.31083/j.rcm2202058 <https://doi.org/10.31083/j.rcm2202058>. 10.31083/j.rcm2202058
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine (General)
spellingShingle R Medicine (General)
Zulastri, Mohd Aizuddin Mohd
Hafidz, Muhammad Imran
Ismail, Muhammad Dzafir
Zuhdi, Ahmad Syadi Mahmood
Hematocrit change as a predictor of readmission for decompensated heart failure: A retrospective single centre study
description In patients with acute heart failure (AHF), hemoconcentration has been suggested as a surrogate for volume changes (AHF). However, literatures comparing the outcome of AHF patients that achieved hemoconcentration during hospitalization with those that do not are limited. The aim of this research is to see if achieving hemoconcentration prior to discharge is linked to a lower risk of re-admission in AHF patients. 124 patients hospitalized in the Cardiology Unit, University Malaya Medical Centre (UMMC) for AHF between November 2019 and November 2020 were enrolled. Information on patients' clinical characteristics, laboratory values and in-hospital treatments were collected through electronic medical record. At admission and discharge, the change in hematocrit (HCT) levels was calculated, and patients were stratified based on two quantiles of delta HCT, either discharged with hemoconcentration (Delta HCT >1.5%) or without hemoconcentration (Delta HCT <= 1.5%). The study's outcome was AHF readmission after a 90-day follow-up period. Readmission was significantly associated with ejection fraction (p = 0.032) and HCT change (p = 0.005). Consecutively, logistic regression performed revealed that patients with haemoconcentration were 78.3% less likely to be readmitted than those without haemoconcentration (OR = 0.217, p = 0.003, 95% CI = 0.078-0.605) and Patients with a lower ejection fraction have a threefold greater chance of being readmitted than those with a preserved ejection fraction (OR = 3.316, p = 0.022, 95% CI = 1.188-9.256). In conclusion, among patients hospitalized and discharged for AHF, those that (i) do not achieve haemoconcentration and (ii) patients with a reduced ejection fraction were more likely to be readmitted with acute heart failure. Therefore, optimising patients' haematocrit levels prior to discharge may potentially reduce rehospitalizations among heart failure patients.
format Article
author Zulastri, Mohd Aizuddin Mohd
Hafidz, Muhammad Imran
Ismail, Muhammad Dzafir
Zuhdi, Ahmad Syadi Mahmood
author_facet Zulastri, Mohd Aizuddin Mohd
Hafidz, Muhammad Imran
Ismail, Muhammad Dzafir
Zuhdi, Ahmad Syadi Mahmood
author_sort Zulastri, Mohd Aizuddin Mohd
title Hematocrit change as a predictor of readmission for decompensated heart failure: A retrospective single centre study
title_short Hematocrit change as a predictor of readmission for decompensated heart failure: A retrospective single centre study
title_full Hematocrit change as a predictor of readmission for decompensated heart failure: A retrospective single centre study
title_fullStr Hematocrit change as a predictor of readmission for decompensated heart failure: A retrospective single centre study
title_full_unstemmed Hematocrit change as a predictor of readmission for decompensated heart failure: A retrospective single centre study
title_sort hematocrit change as a predictor of readmission for decompensated heart failure: a retrospective single centre study
publisher IMR PRESS
publishDate 2021
url http://eprints.um.edu.my/26469/
_version_ 1735409416909357056
score 13.211869

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