Asbagh Amirhosein Ghafouri, Sadeghi Mohammadreza Taban, Ramazanilar Parisa, Nateghian Hooman
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran.
ESC Heart Fail. 2023 Oct;10(5):2837-2842. doi: 10.1002/ehf2.14463. Epub 2023 Jul 5.
Heart failure (HF) is usually associated with complications of other organs. Renal impairment is seen in a significant proportion of HF patients and is characterized by worsening renal function (WRF). WRF can be used for predicting symptom exacerbation in systolic HF. This study aimed to determine the prevalence and risk factors of WRF among hospitalized patients with systolic HF.
In this cross-sectional study, data from medical records of 347 hospitalized patients diagnosed with HFrEF from 2019 to 2020, admitted to Tabriz Shahid Madani Heart Hospital, who met the predefined inclusion criteria, were retrieved. Patients were divided into two groups based on the in-hospital occurrence of WRF. Laboratory tests and para-clinical findings were collected and analysed using SPSS Version 20.0. Statistical significance was accepted at a P value of <0.05. In this study, 347 hospitalized patients with HFrEF were included. The mean (standard deviation) age was 62.34 (±18.87) years. The mean (SD) length of stay was 6.34 (±4) days. According to our findings, 117 patients (33.71%) had WRF. Following multivariate analysis of potential predictors of WRF occurrence, hyponatremia, haemoglobin concentration, white blood cell count and prior diuretic use were found to be independent predictors for WRF occurrence in patients with systolic heart failure.
This study revealed that in patients with WRF, mortality rate and length of stay were significantly greater than those of patients without WRF. Initial clinical characteristics of HF patients who developed WRF can help physicians identify patients with a higher risk of WRF.
心力衰竭（HF）通常与其他器官的并发症相关。相当一部分HF患者存在肾功能损害，其特征为肾功能恶化（WRF）。WRF可用于预测收缩性HF患者症状加重情况。本研究旨在确定住院收缩性HF患者中WRF的患病率及危险因素。
在这项横断面研究中，检索了2019年至2020年入住大不里士沙希德·马达尼心脏病医院、符合预定纳入标准、诊断为射血分数降低的心力衰竭（HFrEF）的347例住院患者的病历数据。根据住院期间是否发生WRF将患者分为两组。收集实验室检查和辅助检查结果，并使用SPSS 20.0版进行分析。P值<0.05时具有统计学意义。本研究纳入了347例住院HFrEF患者。平均（标准差）年龄为62.34（±18.87）岁。平均（标准差）住院时间为6.34（±4）天。根据我们的研究结果，117例患者（33.71%）发生了WRF。在对WRF发生的潜在预测因素进行多变量分析后，发现低钠血症、血红蛋白浓度、白细胞计数和既往利尿剂使用情况是收缩性心力衰竭患者WRF发生的独立预测因素。
本研究表明，发生WRF的患者死亡率和住院时间显著高于未发生WRF的患者。发生WRF的HF患者的初始临床特征可帮助医生识别WRF风险较高的患者。
