| Summary: | In patients with acute heart failure (AHF), hemoconcentration has been suggested
as a surrogate for volume changes (AHF). However, literatures comparing the
outcome of AHF patients that achieved hemoconcentration during hospitalization
with those that do not are limited. The aim of this research is to see if
achieving hemoconcentration prior to discharge is linked to a lower risk of
re-admission in AHF patients. 124 patients hospitalized in the Cardiology Unit,
University Malaya Medical Centre (UMMC) for AHF between November 2019 and
November 2020 were enrolled. Information on patients’ clinical characteristics,
laboratory values and in-hospital treatments were collected through electronic
medical record. At admission and discharge, the change in hematocrit (HCT) levels
was calculated, and patients were stratified based on two quantiles of delta HCT,
either discharged with hemoconcentration (ΔHCT >1.5%) or without
hemoconcentration (ΔHCT ≤1.5%). The study’s outcome was AHF
readmission after a 90-day follow-up period. Readmission was significantly
associated with ejection fraction (p = 0.032) and HCT change (p
= 0.005). Consecutively, logistic regression performed revealed that patients
with haemoconcentration were 78.3% less likely to be readmitted than those
without haemoconcentration (OR = 0.217, p = 0.003, 95% CI = 0.078–0.605)
and Patients with a lower ejection fraction have a threefold greater chance of
being readmitted than those with a preserved ejection fraction (OR = 3.316,
p = 0.022, 95% CI = 1.188–9.256). In conclusion, among patients
hospitalized and discharged for AHF, those that (i) do not achieve
haemoconcentration and (ii) patients with a reduced ejection fraction were more
likely to be readmitted with acute heart failure. Therefore, optimising patients’
haematocrit levels prior to discharge may potentially reduce rehospitalizations
among heart failure patients.
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