Relation between dose of loop diuretics and outcomes in a heart failure population: Results of the ESCAPE Trial
Relation between dose of loop diuretics and outcomes in a heart failure population: Results of the ESCAPE Trial
复制标题
DOI：
10.1016/j.ejheart.2007.07.011
复制
发表时间：
2007-10-01
影响因子：
18.2
通讯作者：
Adams, Kirkwood F., Jr.
中科院分区：
文献类型：
--
作者：
Hasselblad, Vic;Stough, Wendy Gattis;Adams, Kirkwood F., Jr.
背景资料：我们研究了最大住院利尿剂剂量与体重减轻，肾功能变化和住院心力衰竭（HF）patients.Methods死亡率的关系：在ESCAPE，395例患者在医院接受利尿剂。在基线、出院和出院前每隔一天测量体重。体重减轻定义为基线和末次住院体重之间的差异。结果：中位体重减轻：2.8 kg（0.7，6.1）;平均值：3.7 kg（22%的值< 0）。体重减轻和最大住院剂量相关（p = 0.0007）。基线体重、住院时间和基线脑钠肽是体重减轻的重要预测因素。在调整这些因素后，剂量不是体重减轻的重要预测因素。观察到剂量与死亡率之间存在强相关性（p = 0.003），尤其是在> 300 mg/天时。在校正了显著预测死亡率的基线变量后，剂量仍然是死亡率的显著预测因素。最大剂量和肌酐水平变化之间的相关性不显著（r = 0.043; p=0.412）结论：HF住院期间高利尿剂剂量与死亡率增加和6个月预后不良相关。(c)2007年欧洲心脏病学会。Elsevier B. V.出版，保留所有权利。
Background: We examined the relation of maximal in-hospital diuretic dose to weight loss, changes in renal function, and mortality in hospitalised heart failure (HF) patients.Methods: In ESCAPE, 395 patients received diuretics in-hospital. Weight was measured at baseline, discharge, and every other day before discharge. Weight loss was defined as the difference between baseline and last in-hospital weight. Mortality was assessed using a log-logistic model with non-zero background.Results: Median weight loss: 2.8 kg (0.7, 6.1); mean: 3.7 kg (22% of values < 0). Weight loss and maximum in-hospital dose were correlated (p = 0.0007). Baseline weight, length of stay, and baseline brain natriuretic peptide were significant predictors of weight loss. After adjusting for these, dose was not a significant predictor of weight loss. A strong relation between dose and mortality was seen (p = 0.003), especially at > 300 mg/day. Dose remained a significant predictor of mortality after adjusting for baseline variables that significantly predicted mortality. Correlation between maximal dose and creatinine level change was not significant (r-.0.043; p=0.412)Conclusions: High diuretic doses during HF hospitalisation are associated with increased mortality and poor 6-month outcome. (c) 2007 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.