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IMR Press / RCM / Volume 22 / Issue 2 / DOI: 10.31083/j.rcm2202058
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Open Access Original Research
Hematocrit change as a predictor of readmission for decompensated heart failure: a retrospective single centre study
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1 Department of Medicine, University Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia
Academic Editor: Takatoshi Kasai This article belongs to the Special Issue: State-of-the-Art Cardiovascular Medicine in Asia 2021 ().
Rev. Cardiovasc. Med. 2021 , 22(2), 505–512; https://doi.org/10.31083/j.rcm2202058
Submitted: 17 April 2021 | Revised: 28 May 2021 | Accepted: 11 June 2021 | Published: 30 June 2021
Abstract

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 $\leq$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.

Keywords
Heart failure
Haemoconcentration
Re-hospitalisations
Outcome
Decompensated
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