The Role of Urine Na+ Levels as A Predictor of Diuresis Response, Length of Stay, Rehospitalization And Death Due to Cardiovascular Disease In 30 Days Post Treatment in Acute Heart Failure Patients
I Gede Bagus Bhaskara Wijaksana*, I Nyoman Wiryawan, and Luh Oliva Saraswati Suastika
Abstract
Background: The incidence of rehospitalization and death due to cardiovascular disease in acute heart failure (AHF) is relatively high. The spot urine Na+ value 6 and 48 hours after loop diuretic still does not have a clear role as a predictor of diuresis response, length of stay, rehospitalization as well as the composite of rehospitalization events and death due to cardiovascular disease within 30 days. Objective: To determine whether spot urinary Na+ 6 hours and 48 hours after loop diuretic is a predictor of diuresis response, length of stay, rehospitalization as well as a composite of events within 30 days. Methods: This study is a prospective cohort of AHF patients treated in February-March 2024. The independent variable is the spot urine Na+ value 6 and 48 hours after loop diuretic. Outcomes consist of diuresis response, length of stay, rehospitalization as well as a composite of rehospitalization and death due to cardiovascular disease within 30 days. Results: A total of 72 AHF patients were included in the study. Rehospitalization events occurred in 20.8% of cases while composite events occurred in 22.2%. The cut point value for spot urinary Na+ 6 hours after loop diuretic in this study was 62.3 mmol/L. 6-hour spot urine Na+ was a predictor of poor diuresis response with adjusted OR 3.67 (95% CI 1.12-11.8; p < 0.03). Regression analysis showed that 6-hour spot urine Na+ was not a predictor of length of stay (β coefficient: -0,023 95% CI -0,054 – 0,008; p = 0.138). 6-hour spot urine Na+ was a predictor of rehospitalization with adjusted HR 3.53 (95% CI 1.11-11.18; p = 0.032). The 6-hour spot urine Na+ value was a composite predictor of 30-day events with HR 4.89 (95% CI 1.58-15.11; p = 0.006). No association was found between 48-hour spot urine Na+ values with diuresis response, length of stay, rehospitalization and events within 30 days. Conclusion: Spot urine Na+ value 6 hours after loop diuretic is a predictor of diuresis response, rehospitalization and composite events within 30 days. The 6-hour urine Na+ spot value is not a predictor of length of stay. The 48-hour urine Na+ spot value is not a predictor of diuresis response, length of stay, rehospitalization or composite events within 30 days.
Keywords
Spot urine Na+ ; diuresis response; length of stay; acute heart failure; rehospitalization; death from cardiovascular disease
Cite This Article
Wijaksana, I. G. B. B., Wiryawan, I. N., Suastika, L. O. S. (2024). The Role of Urine Na+ Levels as A Predictor of Diuresis Response, Length of Stay, Rehospitalization And Death Due to Cardiovascular Disease In 30 Days Post Treatment in Acute Heart Failure Patients. International Journal of Scientific Advances (IJSCIA), Volume 5| Issue 3: May-Jun 2024, Pages 553-572, URL: https://www.ijscia.com/wp-content/uploads/2024/06/Volume5-Issue3-May-Jun-No.617-553-572.pdf
Volume 5 | Issue 3: May-Jun 2024
