Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain.
Emergency Department, Hospital Universitari de Vic, Barcelona, Spain.
Eur J Intern Med. 2019 Sep;67:89-96. doi: 10.1016/j.ejim.2019.07.010. Epub 2019 Jul 20.
To study the outcomes of patients with acute heart failure (AHF) presenting renal dysfunction (RD) or hyperkalaemia (Hk) alone or in combination.
We analysed the data of the EAHFE registry, a multicentre, non interventionist cohort with prospective follow-up of patients with AHF. Four groups were defined based on the presence or not of RD or Hk alone or in combination. The primary endpoint was 30-day all-cause mortality.
A total of 11,935 of the 13,791 patients included in the EAHFE registry were analysed. Of these, 5088 (42.6%) did not have RD or Hk (NoRD-NoHk), 150 (1.3%) had no RD but had Hk (NoRD-Hk), 6012 (50.4%) had RD but not Hk (RD-NoHk) and 685 (5.7%) had both RD and Hk (RD-Hk). Thirty-day all-cause mortality was greatest in the RD-Hk group with an adjusted Hazard Ratio (HR) of 2.44 (confidence interval 95% [CI95%] 1.67-3.55; p < 0.001) and in the RD-NoHk group with an adjusted HR of 1.34 (CI95% 1.04-1.71; p = 0.022). There were no significant differences in in-hospital mortality and reconsultation at 30 days for HF. For the combined endpoint of 30-day all-cause mortality the adjusted HR was 1.33 (CI95% 1.04-1.70); (p = 0.021) for the RD-Hk group.
The association of 30-day all-cause mortality with the presence of RD and Hk in patients presenting AHF at admission is greater than in those without this combination.
研究单独或合并存在急性心力衰竭（AHF）伴肾功能障碍（RD）或高钾血症（Hk）的患者的结局。
我们分析了 EAHFE 注册中心的数据，这是一项多中心、非干预性队列研究，对 AHF 患者进行前瞻性随访。根据是否存在 RD 或 Hk 单独或合并，将患者分为 4 组。主要终点为 30 天全因死亡率。
共分析了 EAHFE 注册中心的 13791 例患者中的 11935 例。其中，5088 例（42.6%）无 RD 或 Hk（NoRD-NoHk），150 例（1.3%）无 RD 但有 Hk（NoRD-Hk），6012 例（50.4%）有 RD 但无 Hk（RD-NoHk），685 例（5.7%）同时有 RD 和 Hk（RD-Hk）。RD-Hk 组 30 天全因死亡率最高，调整后的危险比（HR）为 2.44（95%置信区间[CI95%]1.67-3.55；p<0.001），RD-NoHk 组调整后的 HR 为 1.34（CI95%1.04-1.71；p=0.022）。住院死亡率和 30 天内因 HF 再次就诊率无显著差异。对于 30 天全因死亡率的联合终点，调整后的 HR 为 1.33（CI95%1.04-1.70）；（p=0.021）对于 RD-Hk 组。
与入院时存在 AHF 的患者中 RD 和 Hk 相比，RD 和 Hk 同时存在与 30 天全因死亡率相关。
