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Year : 2021  |  Volume : 22  |  Issue : 2  |  Page : 108-114

The effect of early aggressive diuresis on hospital length of stay in acute congestive heart failure

1 Heart and Vascular Center, Case Western Reserve University/MetroHealth Medical Center, Ohio, USA
2 Department of Internal Medicine, Mercy Hospital of Buffalo, The State University of New York at Buffalo, New York, USA
3 Gill Heart and Vascular Institute, University of Kentucky, Kentucky, USA
4 Department of Internal Medicine, Cleveland Clinic Akron General, Ohio, USA
5 Section of Cardiology, Baylor College of Medicine, Houston, Texas, USA
6 Department of Cardiology, Saint Joseph Hospital CHI Commonspirit, Kentucky, USA

Correspondence Address:
Dr. Anas Alameh
1-Akron General Ave, Akron 44307, Ohio
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Source of Support: None, Conflict of Interest: None


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Background: Diuresis is the mainstay of treatment during hospitalization for patients admitted with congestive heart failure (CHF). Hospital length of stay (LOS) is considered an important patient outcome for CHF patients; previous studies comparing higher rates of diuresis (aggressive) versus relatively lower rates (nonaggressive) on patient outcomes have shown contradicting results. In fact, no specific guidelines to direct diuretic therapy exist. This investigation was designed to study the effect of early aggressive diuresis on hospital LOS. Methods: Data from 194 CHF patients (admitted to the hospital for 1 year) were collected and analyzed in a retrospective cohort study design. Patients were divided into two cohorts based on urine output achieved in the first 24 h of admission; the aggressive diuresis cohort (urine output ≥2400 mL) comprised of 29 subjects while the nonaggressive diuresis cohort (urine output ≤2400 mL) had 165 subjects. The primary endpoint was LOS. Results: Median LOS for the aggressive diuresis cohort was 4 days (95% confidence interval [CI]: 2.95–5.06) as compared to 5 days (95% CI 4.40–5.60) for the nonaggressive diuresis cohort; log-rank test showed no significant differences between the hospitalized proportions between the two cohorts over time (P = 0.67). Conclusion: Hospital LOS for CHF patients treated with early aggressive diuresis was not significantly different compared to patients treated with nonaggressive diuresis.

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