Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12872-017-0669-0
Title: The top tertile of hematocrit change during hospitalization is associated with lower risk of mortality in acute heart failure patients
Authors: Zhou, H
Xu, T
Huang, Y 
Zhan, Q
Huang, X
Zeng, Q
Xu, D
Keywords: amino terminal pro brain natriuretic peptide
acute heart failure
aged
all cause mortality
Article
controlled study
female
heart left ventricle ejection fraction
hematocrit
hemoconcentration
hemodilution
hospital patient
human
major clinical study
male
New York Heart Association class
observational study
priority journal
prognosis
retrospective study
survival rate
acute disease
blood
cause of death
chi square distribution
erythrocyte
heart failure
hospital admission
hospital discharge
hospitalization
Kaplan Meier method
middle aged
mortality
multivariate analysis
predictive value
procedures
proportional hazards model
risk assessment
risk factor
time factor
very elderly
Acute Disease
Aged
Aged, 80 and over
Cause of Death
Chi-Square Distribution
Erythrocytes
Female
Heart Failure
Hematocrit
Hemodilution
Hospitalization
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Patient Admission
Patient Discharge
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Issue Date: 2017
Citation: Zhou, H, Xu, T, Huang, Y, Zhan, Q, Huang, X, Zeng, Q, Xu, D (2017). The top tertile of hematocrit change during hospitalization is associated with lower risk of mortality in acute heart failure patients. BMC Cardiovascular Disorders 17 (1) : 235. ScholarBank@NUS Repository. https://doi.org/10.1186/s12872-017-0669-0
Rights: Attribution 4.0 International
Abstract: Background: Hemoconcentration has been proposed as surrogate for changes in volume status among patients hospitalized with acute heart failure (AHF) and is associated with a favorable outcome. However, there is a dearth of research assessing the clinical outcomes of hospitalized patients with hemoconcentration, hemodilution and unchanged volume status. Methods: We enrolled 510 consecutive patients hospitalized for AHF from April 2011 to July 2015. Hematocrit (HCT) levels were measured at admission and either at discharge or on approximately the seventh day of admission. Patients were stratified by delta HCT tertitles into hemodilution ((increment)HCT ≤ - 1.6%), no change (NC, -1.6% < (increment)HCT ≤1.5%) and hemoconcentration ((increment)HCT >1.5%) groups. The endpoint was all-cause death, with a median follow-up duration of 18.9 months. Results: Hemoconcentration was associated with lower left ventricle ejection fraction, as compared with NC and hemodilution groups, while renal function at entry, New York Heart Association class IV, and in-hospital worsening renal function (WRF) were not significantly different across the three groups. After multivariable adjustment, hemoconcentration had a lower risk of mortality as compared with hemodilution [hazard ratio (HR) 0.39, 95% confidence interval (CI) 0.24-0.63, P < 0.001], or NC (HR 0.54, 95% CI 0.33-0.88, P = 0.015], while hemodilution and NC did not have significantly differ in mortality (HR 0.72, 95% CI 0.48-1.10, P = 0.130). Conclusions: In patients hospitalized with AHF, an increased HCT during hospitalization is associated with a lower risk of all-cause mortality than a decreased or unchanged HCT. Furthermore, all-cause mortality does not differ significantly between patients with unchanged and decreased HCT values. © 2017 The Author(s).
Source Title: BMC Cardiovascular Disorders
URI: https://scholarbank.nus.edu.sg/handle/10635/181249
ISSN: 14712261
DOI: 10.1186/s12872-017-0669-0
Rights: Attribution 4.0 International
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