ASSOCIATION OF DOOR TO DIURETIC TIME ON MORTALITY AND MORBIDITY IN ACUTE HEART FAILURE
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Keywords
acute heart failure, reduced ejection fraction, preserved ejection fraction, readmission, mortality
Abstract
This study was prospective, observational study of patients hospitalized for acute heart failure (AHF). All patients were followed up for six months after the index hospitalization. Early group (n = 137) received IV diuretics within 90 minutes while as Delayed group (n = 293) received IV diuretics after 90 minutes. Demographic parameters like age, gender and comorbid illness was compared in patients in Early Group and Delayed Group and the association was found to be statistically insignificant (p >0.05). Insignificant statistical difference was observed when smoking status was compared between two study groups. There were 21.9% smokers in Early Group compared to 17.4% smokers in Delayed Group. On echocardiography, heart failure with preserved ejection fraction (HFpEF) was observed in 48.1% patients, heart failure with reduced ejection fraction (HFrEF) was seen in 39.1% patients and 12.8% patients had heart failure with midrange ejection fraction (HFmrEF). In-hospital mortality was higher in Delayed Group (12.3%) compared to Early Group (5.1%) with significant statistical difference (p < 0.05). Mean length of hospitalization was shorter in Early Group (14.7 days) compared to 17.3 days in Delayed Group (P < 0.05). Readmission at 1 month in two study groups was found to be statistically insignificant (p>0.05) with 13.9% in Early Group compared to 16.4% in Delayed Group. Readmission at 6 month was again higher in Delayed Group 12.3% versus 9.5% in Early Group with an insignificant statistical association (p > 0.05). At one month significantly higher mortality was observed in Delayed Group (14.3%) compared to 7.3% in Early Group (p<0.05). At 6 month, there was higher mortality in Delayed Group (22.9%) compared to 13.1% in Early Group with a statistically significant association between (p <0.05).
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Dr Irfan Ahmad Bhat
(Assistant Professor) Postgraduate Department of Medicine, Government Medical College, Srinagar, J&K
Dr Inayat Ullah Pall
(Senior Resident) Postgraduate Department of Medicine, Government Medical College, Srinagar, J&K
Dr Samia Rashid
(Professor and Ex-Head) Postgraduate Department of Medicine, Government Medical College, Srinagar, J&K