Admission inferior vena cava measurements are associated with mortality after hospitalization for acute decompensated heart failure. Issue 11 (6th June 2016)

• Record Type: Journal Article
• Authors: Cubo‐Romano, Pilar; Torres‐Macho, Juan; Soni, Nilam J.; Reyes, Luis F.; Rodríguez‐Almodóvar, Ana; Fernández‐Alonso, Juan Manuel; González‐Davia, Rosa; Casas‐Rojo, José Manuel; Restrepo, Marcos I.; de Casasola, Gonzalo García
• Is Part Of: Journal of hospital medicine. Volume 11:Issue 11(2016)
• Page Start: 778
• Page End: 784
• Publication Date: 2016-06-06
• Subjects: Hospital care -- Periodicals; Clinical medicine -- Periodicals; 610
• DOI: 10.1002/jhm.2620
• Languages: English
• ISSNs: 1553-5592

Abstract

Abstract : BACKGROUND: Prognostication of patients hospitalized with acute decompensated heart failure (ADHF) is important to patients, providers, and healthcare systems. Few bedside tools exist to prognosticate patients hospitalized with ADHF. OBJECTIVE: The objective of this study was to assess the relationship between inferior vena cava (IVC) diameter and postdischarge mortality in patients hospitalized with ADHF. DESIGN: Prospective observational study. SETTING: A 247‐bed urban teaching hospital in Spain PATIENTS: Ninety‐seven patients hospitalized with ADHF. INTERVENTION: None. MEASUREMENTS: The IVC diameter and collapsibility were measured by a hospitalist at the time of admission and discharge. Primary outcome was 90‐day all‐cause mortality. Secondary outcomes were readmission rates at 90 and 180 days, and 180‐day all‐cause mortality. Patients were followed for 180 days. RESULTS: Data from 80 patients were analyzed. From admission to discharge, a significant improvement in IVC maximum (IVCmax ) diameter (2.12 vs 1.87 cm; P < 0.001) and IVC collapsibility (25.7% vs 33.1%; P < 0.001) was seen in the total study cohort. During the 90‐day follow‐up period, 11 patients (13.7%) died. An admission IVCmax diameter ≥1.9 cm was associated with a higher mortality rate at 90 days (25.4% vs 3.4%; P = 0.009) and 180 days (29.3% vs 3.4%; P = .003). In a multivariate Cox proportional hazards regression analysis, admission IVCmax diameter was an independent predictor of 90‐day mortality (hazard ratio [HR]: 5.88; 95% confidence interval [CI]: 1.21‐28.10; P = 0.025) and 90‐day readmission (HR: 3.20; 95% CI: 1.24‐8.21; P = 0.016). CONCLUSION: In patients hospitalized with acute decompensated heart failure, a dilated IVC by bedside ultrasound at the time of admission is associated with a higher 90‐day mortality after hospitalization. Journal of Hospital Medicine 2016;11:778–784. © 2016 Society of Hospital Medicine