Thesis
Aggressive Diuresis and Severity-Adjusted Length of Hospital Stay in Acute Congestive Heart Failure Patients.
(2018)
Abstract
To see if aggressive diuresis in 1st 24 hours is associated with a comparable number of total days in the hospital as compared to non-aggressive diuresis. In this retrospective cohort study, we compared the length of hospital stay of consecutive patients admitted in one year based on their diuresis during the first twenty-four hours of hospitalization: aggressive diuresis (group 1) i.e. >2400mL versus non-aggressive diuresis (group 2) i.e. ≤ 2400mL urine output. Patients were excluded if in cardiogenic shock, had creatinine level above 3 mg/dL on admission, or on dialysis. A total of 194 patients were enrolled (29 in group 1 and 165 in group 2 respectively). The Kaplan-Meier estimate of the median cumulative proportion of patients still hospitalized for the group 1 was 4 days and in group 2 was 5 days (log-rank test; P=0.67). In univariate analysis, Cox PH regression showed unadjusted hazard rate of discharge from hospital was slightly higher in group 1 than group 2 but was statistically non-significant (HR=1.08; P=0.70). In multivariate Cox model analysis, creatinine at the time of admission when greater than 1.6mg/dL (P=0.75), LVEF (P= 0.14), total twenty-four hours dose of intravenous Furosemide given (P=0.98) and interaction between Furosemide dose and Creatinine level (P=0.79) were not significant predictor of hospital discharge. Adjusted hazard rate for discharge from hospital was 12% higher in group 1 than group 2 but still statistically non-significant (HR=1.12; P=0.60). Since the length of hospital stay is similar between two groups, we suggest the goal of diuresis to be less than 2400mL in 1st 24 hours to prevent excessive dehydration.
Keywords
- Aggressive Diuresis,
- Furosemide,
- length of hospital stay,
- Chronic Kidney Disease
Disciplines
Publication Date
Summer April 30, 2018
Degree
Masters of Science in Clinical Research Design (MSCRD)
Field of study
Clinical Research Design
Department
College of Public Health
Advisor
David Mannino M.D.
Citation Information
Muhammad U Butt. "Aggressive Diuresis and Severity-Adjusted Length of Hospital Stay in Acute Congestive Heart Failure Patients." (2018) Available at: http://works.bepress.com/muhammad-butt/1/