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Determining the role of intravenous hydration on hospital readmissions for acute congestive heart failure

Munish Sharma, Ravi Kumar Patel, Mahesh Krishnamurthy, Richard Snyder
  • Munish Sharma
    Department of Internal Medicine, Easton Hospital, Easton, PA, United States | munishs1@hotmail.com
  • Ravi Kumar Patel
    Department of Internal Medicine, Easton Hospital, Easton, PA, United States
  • Mahesh Krishnamurthy
    Department of Internal Medicine, Easton Hospital; Clinical Medicine, Drexel University College of Medicine, Easton, PA, United States
  • Richard Snyder
    Department of Nephrology, Easton Hospital, Easton, PA, United States

Abstract

The role of intravenous hydration on hospital readmissions due to acute exacerbation of congestive heart failure (CHF) has not been studied sufficiently to the best of our knowledge. We sought to determine the possible role of intravenous hydration on hospital readmissions for acute CHF and fluid overload and explain how an intravenous fluid (IVF) restriction strategy may help reduce hospital readmission rates. We retrospectively studied the electronic medical records of 98-patient cohort who had hospital readmission due to acute decompensated congestive heart failure (ADHF) during the period of January 1, 2016 to July 9, 2016. These patients were admitted with reasons other than ADHF during the index admission. The patients were divided into two groups; those with ADHF readmissions within 15 days of index admission (group A) and those after 15 days (group B). Various factors affecting CHF readmissions as outlined in the results were compared between these two groups. Cohort of 98 patients (53 females, 54.1%; 76.4±11.6 years) re-admitted during the study period of 1/1/2016 to 7/9/2016 were analyzed. 71 patients had only received IVF during index admission. These were subdivided into group A (12 females, 54.5 %; mean age 75.9±12.9 years) and group B (25 females, 51.02%; mean age 76.08±11.90 years) based on readmission ≤15 days or >15 days from the index admission. There was no statistically significant difference (P=0.97) in amount of IVF prescribed between two subgroups but the duration of prescribed IVF significantly affected readmission in group A compared to group B (P=0.03). While the drop in albumin and rise in creatinine were not significant, the mean hemoglobin (Hb) drop in group A compared to group B was significant at P=0.008. Type of IVF and nature of CHF (heart failure with reduced ejection fraction, HFrEF/heart failure with preserved ejection fraction, HFpEF) were not found to significantly affect early readmissions associated with IV hydration. In patients with history of CHF, duration of IVF prescribed during the index admission seems to play important role in early CHF readmission (defined as <15 days in our study).

Keywords

Congestive heart failure; intravenous hydration; hospital readmissions.

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Submitted: 2017-05-16 04:14:18
Published: 2018-01-08 09:26:50
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Copyright (c) 2018 Munish Sharma, Ravi Kumar Patel, Mahesh Krishnamurthy, Richard Snyder

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