Author ORCID Identifier
Date Available
5-2-2018
Year of Publication
2018
Document Type
Master's Thesis
Degree Name
Master of Science (MS)
College
Public Health
Department/School/Program
Clinical Research Design
Advisor
Dr. David Mannino
Abstract
To see if aggressive diuresis in first twenty four hours is associated with a comparable number of total days in the hospital as compared to non-aggressive diuresis. In this retrospective cohort study, we compared the length of hospital stay of consecutive patients admitted in one year based on their diuresis during the first twenty-four hours of hospitalization: aggressive diuresis (group 1) i.e. > 2400mL versus non-aggressive diuresis (group 2) i.e. ≤ 2400mL urine output. Patients were excluded if in cardiogenic shock, had creatinine level above 3 mg/dL on admission, or on dialysis. A total of 194 patients were enrolled (29 in group 1 and 165 in group 2 respectively). The Kaplan-Meier estimate of the median cumulative proportion of patients still hospitalized for the group 1 was 4 days and in group 2 was 5 days (log-rank test; P=0.67). In univariate analysis, Cox PH regression showed unadjusted hazard rate of discharge from hospital was slightly higher in group 1 than group 2 but was statistically non-significant (HR=1.08; P=0.70). In multivariate Cox model analysis, creatinine at the time of admission when greater than 1.6mg/dL (P=0.75), LVEF (P= 0.14), total twenty-four hours dose of intravenous Furosemide given (P=0.98) and interaction between Furosemide dose and Creatinine level (P=0.79) were not significant predictor of hospital discharge. Adjusted hazard rate for discharge from hospital was 12% higher in group 1 than group 2 but still statistically non-significant (HR=1.12; P=0.60). Since the length of hospital stay is similar between two groups, we suggest the goal of diuresis to be less than 2400mL in first twenty-four hours to prevent excessive dehydration.
Digital Object Identifier (DOI)
https://doi.org/10.13023/ETD.2018.191
Recommended Citation
Butt, Muhammad U., "AGGRESSIVE DIURESIS AND SEVERITY-ADJUSTED LENGTH OF HOSPITAL STAY IN ACUTE CONGESTIVE HEART FAILURE PATIENTS" (2018). Theses and Dissertations--Clinical Research Design. 2.
https://uknowledge.uky.edu/crd_etds/2
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Biostatistics Commons, Cardiology Commons, Cardiovascular Diseases Commons, Clinical Epidemiology Commons
