Effect of Baseline Covariates on Mortality Risk in the Vasodilation in the Management of Acute Congestive Heart Failure (VMAC) Trial

Abstract Background Mortality risk for hemodialysis (HD) patients varies by country and ethnicity. Here, mortality rate and its related risk factors in Chinese HD patients from the Dialysis Outcomes and Practice Patterns Study (DOPPS) were investigated.Methods Data from China DOPPS phase 5 (2012–2015) were used. Patients’ demographics, assigned primary causes of end stage Kidney disease (ESKD), comorbidities, dialysis prescription, laboratory values, date and cause for death were analyzed. Cox proportional hazards models were used to assess the association of patient characteristics and treatments with mortality.Results 1427 HD patients were enrolled. The mean age was 59.4 ± 14.9 years. The median follow-up time was 1.9 (1.1–2.1) years. There was total 205 deaths with at least 103 from cardiovascular disease (50.2%). The overall mortality rate was 8.8 per 100 patient-years. In the multivariate COX model, older, serum albumin (Alb < 4g/dl, blood platelets < 100*109/L, pulse pressure (PP) > 63mmHg, and congestive heart failure history were independent risk factors for all-cause mortality.Conclusions Attention should be paid to patients who were older, with lower Alb and blood platelets level, higher PP and congestive heart failure history. Our results highlighted that there might be some modifiable risk factors for patients’ survival, such as Hgb, Alb, blood platelets, and blood pressure management.

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Prevalence and Mortality of Hypochloremia Among Patients Suffering From Coronary Artery Disease and Congestive Heart Failure: An Analysis of Patients in CIN-I and MIMIC-III Databases

Frontiers in Medicine ◽

10.3389/fmed.2021.769646 ◽

2021 ◽

Vol 8 ◽

Author(s):

Haozhang Huang ◽

Jin Liu ◽

Yan Liang ◽

Kunming Bao ◽

Linfang Qiao ◽

...

Keyword(s):

Heart Failure ◽

Coronary Artery Disease ◽

Congestive Heart Failure ◽

Coronary Artery ◽

Mortality Risk ◽

Medical Information ◽

Short Term ◽

Artery Disease ◽

Mimic Iii

Background: Hypochloremia is an independent predictor for mortality in patients with coronary artery disease (CAD) but whether the same correlation exists in CAD patients with congestive heart failure (CHF) is unclear.Methods: This is an analysis of data stored in the databases of the CIN-I [a registry of Cardiorenal Improvement (NCT04407936) in China from January 2007 to December 2018] and Medical Information Mart for Intensive Care (MIMIC)-III. CAD patients with CHF were included. The outcome measures were 90-day all-cause mortality (ACM) and long-term ACM.Results: Data from 8,243 CAD patients with CHF were analyzed. We found that 10.2% of the study population had hypochloremia (Cl− <98 mmol/L) in CIN-I (n = 4,762) and 20.1% had hypochloremia in MIMIC-III (n = 3,481). Patients suffering from hypochloremia were, in general, older and had a higher prevalence of comorbidities. After adjustment for confounders, hypochloremia remained a significant predictor of short-term mortality risk [90-day ACM: adjusted hazard ratio (aHR), 1.69; 95% CI, 1.27–2.25; P < 0.001 in CIN-I, and 1.36 (1.17–1.59); P < 0.001 in MIMIC-III]. Hypochloremia was also associated with long-term mortality [aHR, 1.26; 95% CI, 1.06–1.50; P = 0.009 in CIN-I, and 1.48 (1.32–1.66); P < 0.001 in MIMIC-III]. Prespecified subgroup analyses revealed an association of hypochloremia with long-term ACM to be attenuated slightly in the women of the two databases (P interaction < 0.05).Conclusions: Hypochloremia is independently associated with higher short-term and long-term ACM. Further studies are needed to determine if early preventive measurements and active intervention of hypochloremia can reduce the mortality risk of CAD patients with CHF.

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Mortality Risk Factors in the China Dialysis Outcomes and Practice Patterns Study (DOPPS)

10.21203/rs.3.rs-445338/v2 ◽

2021 ◽

Author(s):

Xinju Zhao ◽

Qingyu Niu ◽

Zhaohui Ni ◽

Xiaonong Chen ◽

Yuqing Chen ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Congestive Heart Failure ◽

Mortality Rate ◽

Mortality Risk ◽

Practice Patterns ◽

Cox Model ◽

Blood Platelets ◽

Cox Proportional Hazards ◽

Dialysis Outcomes

Abstract Background Mortality risk for hemodialysis (HD) patients varies by country and ethnicity. Here, mortality rate and its related risk factors in Chinese HD patients from the Dialysis Outcomes and Practice Patterns Study (DOPPS) were investigated. Methods Data from China DOPPS phase 5 (2012–2015) were used. Patients’ demographics, assigned primary causes of end stage kidney disease (ESKD), comorbidities, dialysis prescription, laboratory values, date and cause for death were analyzed. Cox proportional hazards models were used to assess the association of patient characteristics and treatments with mortality. Results 1427 HD patients were enrolled. The mean age was 59.4 ± 14.9 years. The median follow-up time was 1.9 (1.1–2.1) years. There was total 205 deaths with at least 103 from cardiovascular disease (50.2%). The overall mortality rate was 8.8 per 100 patient-years. In the multivariate Cox model, older, serum albumin (Alb < 4g/dl, blood platelets < 100*109/L, pulse pressure (PP) > 63mmHg, and congestive heart failure history were independent risk factors for all-cause mortality. Conclusions Attention should be paid to patients who were older, with lower Alb and blood platelets level, higher PP and congestive heart failure history. Our results highlighted that there might be some modifiable risk factors for patients’ survival, such as Hgb, Alb, blood platelets, and blood pressure management.

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