Worsening renal function increased mortality, readmission risks among acute HF patients

LAS VEGAS — Patients with acute HF who experienced worsening renal function, particularly persistently worsening function, were at increased risk for mortality and all-cause hospital readmission than those who did not, according to data presented at the Heart Failure Society of American Annual Scientific Meeting.

Researchers evaluated 27,309 patients aged 65 years or older (mean age, approximately 80 years) hospitalized for acute HF between 2003 and 2006, according to data from the ADHERE registry and linked Medicare claims. Patients with an increase in serum creatinine of 0.3 mg/dL from hospital admission were classified as experiencing worsening renal function (WRF). Those with a difference of less than 0.3 mg/dL between last recorded creatinine levels and that of admission were classified as having transient WRF, whereas those with a difference of at least 0.3 mg/dL were classified as having persistent WRF.

No WRF was observed in 18,568 patients, whereas 3,205 had transient WRF and 5,536 had persistent WRF. Rates of all-cause readmission within 90 days of discharge and mortality within 90 days of admission were significantly higher among those with transient or persistent WRF compared with those without WRF. No difference was observed between the groups regarding HF-related readmission at 90 days postdischarge.

The link between mortality and transient or persistent WRF remained significant on adjusted analysis; however, no significant differences in risk for all-cause or HF-related readmission were observed.

The researchers said patients with transient WRF were at significantly increased risk for mortality at 90 days after admission than those with transient WRF (HR=1.46; 99% CI, 1.28-1.66).

“Both transient and persistent WRF during acute HF were associated with increased 90-day risk for all-cause mortality, with worse outcomes in most patients with persistent WRF,” Arun Krishnamoorthy, MD, of Duke University School of Medicine, said during his presentation here. “Prevention of any WRF during acute HF hospitalization remains important.”

For more information:

Krishnamoorthy A. Abstract #037. Rapid-Fire Abstracts II. Presented at: the Heart Failure Society of American Annual Scientific Meeting; Sept. 14-17, 2014; Las Vegas.

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