期刊
JOURNAL OF CARDIAC FAILURE
卷 28, 期 7, 页码 1116-1124出版社
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.cardfail.2021.11.017
关键词
improved heart failure; weight loss; outcomes
资金
- National Institutes of Health from the National Heart, Lung, and Blood Institute [R01HL085561, R01-HL097047]
- Department of Veterans Affairs from the Office of Research and Development, [I01HX002422]
- Health Services Research and Development
- GlaxoSmithKline
In-hospital weight loss in patients with acute decompensation of heart failure may be associated with lower risk of mortality and readmission.
Background: Acute decompensation of heart failure (HF) is often marked by fluid retention, and weight loss is a marker of successful diuresis. We examined the relationship between in -hospital weight loss and post-discharge outcomes in patients with HF. Methods: We conducted a propensity score-matched study of 8830 patients hospitalized for decompensated HF in the Medicare-linked Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry, in which 4415 patients in the weight-loss group and 4415 patients in the no-weight-loss group were balanced on 75 baseline characteristics. We defined weight loss as an admission-to-discharge weight loss of 1-30 kilo-grams, and we defined no weight loss as a weight gain or loss of < 1 kilogram. Hazard ratios (HRs) and 95% confidence intervals (CIs) for outcomes associated with weight loss were estimated. Results: Patients had a mean age of 78 years, 57% were women, and 11% were African American. The median weight loss in the weight-loss group was 3.6 (interquartile range, 2.0-6.0) kilograms. HRs and 95% CIs for 30-day all-cause mortality, all-cause readmission and HF readmission associated with weight loss were 0.75 (0.63-0.90), 0.90 (0.83-0.99) and 0.83 (0.72-0.96), respectively. Respective 60-day HRs (95% CIs) were 0.80 (0.70-0.92), 0.91 (0.85-0.98) and 0.88 (0.79-0.98). These associations were attenuated and lost significance during 6 months of follow-up. Conclusions: Among older patients hospitalized for decompensated HF, in-hospital weight loss was associated with a lower risk of mortality and hospital readmission. These findings sug-gest that in-hospital weight loss, a marker of successful diuresis and decongestion, is also a marker of improved clinical outcomes.
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