Predicting In-Hospital Acute Heart Failure Worsening in the Oldest Old: Insights from Point-of-Care Ultrasound
Abstract
:1. Introduction
2. Materials and Methods
- at least a 10% reduction in P/F ratio
- an increase on dosage of diuretic therapy,
- onset of pulmonary edema during hospitalization, and
- in-hospital death.
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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All Patients n = 184 | Adverse Event n = 60 | Controls n = 124 | p-Value | |
---|---|---|---|---|
Gender F (%) | 67 (58) | 25 (62.5) | 49 (56.3) | 0.95 |
Mean Age (years) | 86.8 (5.9) | 87.2 (5.9) | 86.6 (5.8) | 0.51 |
Mean BMI | 24.6 (4.5) | 24.3 (4.3) | 24.4 (4.5) | 0.85 |
Median CFS | 6 (3) | 5.5 (3) | 6 (3) | 0.55 |
Arterial Hypertension (%) | 121 (66.2) | 41 (69.6) | 80 (64.6) | 0.517 |
Atrial Fibrillation (%) | 118 (63.9) | 47 (78.5) | 70 (56.8) | 0.006 |
Coronary Artery Disease (%) | 65 (35.4) | 29 (48.2) | 36 (29.3) | 0.001 |
Diabetes Mellitus (%) | 53 (29.0) | 15 (25.0) | 38 (31.0) | 0.414 |
Peripheral Artery Disease (%) | 49 (26.7) | 15 (25.0) | 34 (27.5) | 0.720 |
Cancer (%) | 37 (20.4) | 7 (12.4) | 30 (24.1) | 0.076 |
Chronic Kidney Disease (%) | 58 (31.9) | 21 (35.7) | 37 (30.1) | 0.46 |
Chronic Obstructive Pulmonary Disease (%) | 48 (26.1) | 19 (32.1) | 28 (23.2) | 0.21 |
History of Stroke (%) | 33 (18.0) | 11 (17.8) | 22 (18.1) | 0.96 |
Median B-lines | 12 (12) | 13 (15.2) | 11 (13) | 0.18 |
PEFs cumulative | 2 (5) | 4 (5) | 2 (4) | 0.005 |
IVC max (mm) | 17.7 (5.2) | 18.2 (5.1) | 17.2 (5.2) | 0.27 |
IVC min (mm) | 9.8 (7.2) | 12.2 (7.5) | 8.2 (6.9) | 0.002 |
Delta IVC (mm) | 7.8 (5.2) | 6 (4.9) | 8.9 (5.2) | 0.002 |
EPSS (mm) | 6.1 (3.2) | 4.9 (2.4) | 6.8 (3.5) | 0.024 |
NT-proBNP max (ng/L) | 14,430.7 (28,237.2) | 15,504 (13,858.5) | 14,525.2 (33,945.3) | 0.84 |
NT-proBNP min (ng/L) | 8616.3 (28,885.9) | 7050.4 (7710.7) | 9536.8 (35,647.2) | 0.63 |
Serum Creatinine (mg/dL) | 1.39 (0.71) | 1.45 (0.75) | 1.26 (0.59) | 0.21 |
Hospital stays (days) | 7 (3) | 8 (3) | 6.5 (3) | 0.004 |
P/F at admission | 311.3 (93.7) | 296 (99.2) | 318.5 (91.4) | 0.15 |
HCO3− admission | 25.4 (4.4) | 26.2 (4.5) | 25 (4.2) | 0.09 |
HCO3− at discharge | 29.3 (5.7) | 29.7 (5.9) | 29.2 (5.7) | 0.58 |
Univariable | Multivariable | |||
---|---|---|---|---|
O.R. (95%CI) | p-Value | O.R. (95%CI) | p-Value | |
PEFs | 1.18 (1.05–1.41) | 0.027 | 1.15 (1.02–1.33) | 0.043 |
IVC collapsibility | 0.84 (0.78–0.90) | 0.021 | 0.90 (0.83–0.95) | 0.039 |
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Mazzarone, T.; Morelli, V.; Giusti, A.; Bianco, M.G.; Maccioni, L.; Cargiolli, C.; Guarino, D.; Virdis, A.; Okoye, C. Predicting In-Hospital Acute Heart Failure Worsening in the Oldest Old: Insights from Point-of-Care Ultrasound. J. Clin. Med. 2023, 12, 7423. https://doi.org/10.3390/jcm12237423
Mazzarone T, Morelli V, Giusti A, Bianco MG, Maccioni L, Cargiolli C, Guarino D, Virdis A, Okoye C. Predicting In-Hospital Acute Heart Failure Worsening in the Oldest Old: Insights from Point-of-Care Ultrasound. Journal of Clinical Medicine. 2023; 12(23):7423. https://doi.org/10.3390/jcm12237423
Chicago/Turabian StyleMazzarone, Tessa, Virginia Morelli, Andrea Giusti, Maria Giovanna Bianco, Lorenzo Maccioni, Cristina Cargiolli, Daniela Guarino, Agostino Virdis, and Chukwuma Okoye. 2023. "Predicting In-Hospital Acute Heart Failure Worsening in the Oldest Old: Insights from Point-of-Care Ultrasound" Journal of Clinical Medicine 12, no. 23: 7423. https://doi.org/10.3390/jcm12237423