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IMPACT OF NATREMIA AND UREA-CREATININE RATIO ON DECOMPENSATED HEART FAILURE
Abstract
Background and Aims
Decompensated heart failure is a common cause of admission to Internal Medicine ward. Urea-creatinine ratio (U/C) and low natremia (Na) previously showed prognostic value in this context. This study aims to assess the impact of both predictors on the hospitalization outcome.
Methods
We retrospectively studied all cases of decompensated heart failure admitted to an Internal Medicine ward during an one year period. Urea-creatinine and Na measures at the hospital admission were recorded. We selected all cause in-hospital death as the primary outcome. The sample was divided in 4 groups: A) U/C < 60 and Na ≥135 mEq/L, B) U/C < 60 and Na < 135 mEq/L, C) U/C ≥ 60 and Na ≥ 135 mEq/L D) U/C ≥ 60 and Na < 135 mEq/L. We performed a multivariate analysis of the predictors using logistic regression.
Results
The study included 271 patients (96 men and 175 women), with a mean age of 79.2 years. Sixty seven (24.7%) patients had U/C ≥ 60. Ninety one (33.6%) had Na < 135 mEq/L. The overall in-hospital mortality was 11.8%. There were differences across the groups (A: 4.4%, B: 14.9%, C: 20.9%, D: 29.2%, p < 0.001). The two markers independently predicted this outcome (U/C > 60: odds ratio 3.7, p=0.001 Na < 135 mEq/L: odds ratio 2.5, p=0.017).
Conclusions
Urea-creatinine ratio and hyponatremia are simple biomarkers that predict increased mortality for decompensated heart failure hospitalizations. These markers could be useful in clinical practice and should be the object of further research.