Pilar Cubo-Romano1,2, Juan Torres-Macho1,2, Nilam J Soni3,4, Luis F Reyes5, Ana Rodríguez-Almodóvar2,6, Juan Manuel Fernández-Alonso7, Rosa González-Davia2,6, José Manuel Casas-Rojo1,2, Marcos I Restrepo5, Gonzalo García de Casasola1,2. 1. Department of Internal Medicine and Emergency Medicine, Infanta Cristina University Hospital, Madrid, Spain. 2. Department of Medicine, Complutense University, Madrid, Spain. 3. Section of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, Texas. sonin@uthscsa.edu. 4. Division of Hospital Medicine, University of Texas School of Medicine in San Antonio, Texas. sonin@uthscsa.edu. 5. Section of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, Texas. 6. Department of Cardiology, Infanta Cristina University Hospital, Madrid, Spain. 7. Department of Biochemistry, Infanta Cristina University Hospital, Madrid, Spain.
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.
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.
Authors: Luke J Laffin; Amit V Patel; Narayan Saha; Julian Barbat; James K Hall; Matthew Cain; Kishan Parikh; Jay Shah; Kirk T Spencer Journal: Int J Cardiovasc Imaging Date: 2018-02-15 Impact factor: 2.357
Authors: Pierpaolo Pellicori; Elke Platz; Jeroen Dauw; Jozine M Ter Maaten; Pieter Martens; Emanuele Pivetta; John G F Cleland; John J V McMurray; Wilfried Mullens; Scott D Solomon; Faiez Zannad; Luna Gargani; Nicolas Girerd Journal: Eur J Heart Fail Date: 2020-11-23 Impact factor: 15.534