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首页> 外文期刊>Journal of Clinical Sciences >Diuretic resistance in patients with heart failure: Clinical characteristics and predictors of outcome
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Diuretic resistance in patients with heart failure: Clinical characteristics and predictors of outcome

机译：心力衰竭患者的利尿耐药性：临床特征和结果预测因素

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Background: Our aim was to study the clinical characteristics and predictors of mortality in heart failure (HF) with diuretic resistance. Methods: We conducted a 5-year retrospective study on 119 HF patients with diuretic resistance at Tikur Anbessa Specialized Teaching Hospital. The primary endpoint was mortality. We compared baseline characteristics and assessed association in patients who received high-dose (≥120 mg) versus low-dose (120 mg) furosemide. Bivariate and multivariate logistic regression analyses were done. Results: Patients receiving high-dose diuretic had significantly higher mean values for age and in New York Heart Association Class IV HF and received a larger dose of hydrochlorothiazide than low-dose patients. They also had significantly higher mean values for systolic blood pressure (SBP), hemoglobin, and serum creatinine. There was no significant difference in mortality between the two groups. On multivariate analysis, association with the high-dose diuretic group remained significant for the higher mean value for SBP and serum creatinine. Independent predictors of mortality were anemia (adjusted odds ratio [AOR]: 4.1, 95% confidence interval [CI]: 1.1–15.2, P = 0.04), infective endocarditis (AOR: 4.9, 95% CI: 2.1–25.7, P = 0.01), and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) (AOR: 3.1, 95% CI: 1.1–9.9, P = 0.04). The use of digoxin was associated with lower mortality (AOR: 0.21, 95% CI: 0.06–0.78, P = 0.01). Conclusions: In HF patients with diuretic resistance, anemia, infective endocarditis, and the use of NSAIDs were independently associated with increased mortality, whereas the use of digoxin was associated with reduced mortality. Early identification and treatment of the risk factors could play a role in reducing mortality.
机译：背景：我们的目标是研究心力衰竭（HF）的临床特征和预测因素，具有利尿耐药性。方法：我们对Tikur Anbessa专业教学医院的119例利尿抗性患者进行了5年的回顾性研究。主要终点是死亡率。我们比较了基线特征和评估患者的评估关联，接受高剂量（≥120mg）与低剂量（<120mg）呋塞米。完成了生物和多变量逻辑回归分析。结果：接受高剂量利尿剂的患者在纽约心脏关联IV级HF中具有显着更高的平均值，并获得比低剂量患者更大的氢氯噻嗪。它们的收缩压（SBP），血红蛋白和血清肌酐也具有显着更高的平均值。两组之间死亡率没有显着差异。在多变量分析上，与高剂量利尿基团的关系对于SBP和血清肌酐的平均值较高。死亡率的独立预测因子是贫血（调整的赔率比[AOR]：4.1,95％置信区间[CI]：1.1-15.2，P = 0.04），感染性心内膜炎（AOR：4.9,95％CI：2.1-25.7，P = 0.01），并使用非甾体抗炎药（NSAIDs）（AOR：3.1,95％CI：1.1-9.9，P = 0.04）。 Digoxin的使用与降低死亡率有关（AOR：0.21,95％CI：0.06-0.78，P = 0.01）。结论：在患有利尿耐药性，贫血，感染性心内膜炎的患者中，与死亡率的增加与NSAIDs的使用无关，而Digoxin的使用与降低的死亡率有关。早期识别和治疗风险因素可能在降低死亡率方面发挥作用。

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