Abstract 11931: Plasma Volume Status at Cardiovascular Intensive Care Unit Discharge and Hospital Discharge is Associated With Overall Survival in Patients With Acute Decompensated Heart Failure

Abstract

Background: Plasma volume status (PVS), a measure of plasma volume, has been evaluated as a prognostic marker for chronic heart failure. However, the significance of PVS in patients with acute decompensated heart failure (ADHF) admitted to the cardiovascular intensive care unit (CICU) remains unclear. Therefore, we examined the relationship between PVS and the long-term mortality. Method: Of 389 consecutive patients admitted to our CICU for ADHF from January 2018 to December 2020, a total of 206 patients (74.9 ± 12.9 years, 64.6% male) were enrolled, excluding those who received red blood cell transfusion, underwent dialysis, were discharged directly from the CICU, or died in the hospital. We measured PVS during the CICU stay and at discharge using the Kaplan-Hakim formula, and examined the association with all-cause mortality during the observation period (1037 days). Result: The group with decreasing PVS at 3 points, at admission to the CICU, at transfer to the GW, and at discharge, had a 3-year mortality rate of 0%. Cut-off values to predict long-term mortality were 10% and 9% for PVS at transfer to the GW and discharge according to ROC curve, respectively. All patients were divided into 2 groups by cut-off values, respectively, and the high PVS group had a significantly higher mortality rate (Figure 1, 2). In COX regression analysis, significant poor prognostic factors were PVS at transfer to the GW (HR=1.086 [1.04-1.13], P<0.001), PVS at discharge (HR=1.073 [1.03-1.12], P<0.001), and age (HR=1.052 [1.00-1.10], P=0.04). In multivariate analysis, PVS at discharge (HR=1.058 [1.00-1.12], P=0.048) was independent poor prognostic factor. Conclusions: In patients with ADHF who were admitted to the CICU, PVS at discharge may be useful in predicting prognosis. It is necessary to consider whether the treatment of heart failure that lowers PVS contributes to improved prognosis.