Predicting the in-Hospital Outcome in Acute Heart Failure: Role of Laboratory Tests

Background: Despite impressive advances in therapeutics in the last years, acute heart failure (AHF) remains a major cause of cardiovascular morbidity and mortality. Additionally, worsening renal failure (WRF) during hospitalization has a significant effect on rehospitalization and mortality in such patients. In this study, we aimed to determine the factors impacting on WRF and inhospital mortality in patients with AHF. Methods: During a 9-month period (September 2016 to May 2017), 104 patients with an episode of AHF (mean age: 75 y) were included in this study. The effects of demographic, echocardiographic, and laboratory findings on WRF and in-hospital outcomes (mortality and urgent heart transplantation) were evaluated retrospectively. Results: Out of the 104 patients, 44.3% developed WRF; the incidence of in-hospital mortality and heart transplantation was 13.4%. Among the laboratory parameters, the specific gravity of urine was significantly associated with WRF (P = 0.03), and higher blood uric acid levels (P = 0.01) and lower left ventricular ejection fractions (P = 0.04) were associated with adverse in-hospital outcomes. Additionally, low hemoglobin (P = 0.03), high pro-BNP (P = 0.05), and low left ventricular ejection fractions (P = 0.04) were associated with a prolonged in-hospital stay. Conclusions: Laboratory data can be used upon patient admission to guide the therapy of heart failure in an attempt to reduce WRF and in-hospital stay.