In-Hospital Weight Loss and Outcomes in Patients With Heart Failure

Authors

Gauravpal S. Gill, Veterans Affairs Medical Center, Washington, D.C.; Creighton University School of Medicine, Omaha, Nebraska.
Phillip H. Lam, Veterans Affairs Medical Center, Washington, D.C.; Creighton University School of Medicine, Omaha, Nebraska; MedStar Washington Hospital Center, Washington, D.C.
Vijaywant Brar, Veterans Affairs Medical Center, Washington, D.C.; Georgetown University, Washington, D.C.; MedStar Washington Hospital Center, Washington, D.C.
Samir Patel, Veterans Affairs Medical Center, Washington, D.C.; George Washington University, Washington, D.C.
Cherinne Arundel, Veterans Affairs Medical Center, Washington, D.C.; Georgetown University, Washington, D.C.; George Washington University, Washington, D.C.
Prakash Deedwania, Veterans Affairs Medical Center, Washington, D.C.; University of California, San Francisco, California.
Charles Faselis, Veterans Affairs Medical Center, Washington, D.C.; George Washington University, Washington, D.C.; Uniformed Services University, Washington, D.C.
Richard M. Allman, George Washington University, Washington, D.C.; University of Alabama at Birmingham, Birmingham, Alabama.
Sijian Zhang, Veterans Affairs Medical Center, Washington, D.C.
Charity J. Morgan, Veterans Affairs Medical Center, Washington, D.C.; University of Alabama at Birmingham, Birmingham, Alabama.
Gregg C. Fonarow, University of California, Los Angeles, California.
Ali Ahmed, Veterans Affairs Medical Center, Washington, D.C.; Georgetown University, Washington, D.C.; George Washington University, Washington, D.C.. Electronic address: ali.ahmed@va.gov.

Document Type

Journal Article

Publication Date

7-1-2022

Journal

Journal of cardiac failure

Volume

28

Issue

7

DOI

10.1016/j.cardfail.2021.11.017

Keywords

heart failure; outcomes; weight loss

Abstract

BACKGROUND: Acute decompensation of heart failure (HF) is often marked by fluid retention, and weight loss is a marker of successful diuresis. We examined the relationship between in-hospital weight loss and post-discharge outcomes in patients with HF. METHODS: We conducted a propensity score-matched study of 8830 patients hospitalized for decompensated HF in the Medicare-linked Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry, in which 4415 patients in the weight-loss group and 4415 patients in the no-weight-loss group were balanced on 75 baseline characteristics. We defined weight loss as an admission-to-discharge weight loss of 1-30 kilograms, and we defined no weight loss as a weight gain or loss of < 1 kilogram. Hazard ratios (HRs) and 95% confidence intervals (CIs) for outcomes associated with weight loss were estimated. RESULTS: Patients had a mean age of 78 years, 57% were women, and 11% were African American. The median weight loss in the weight-loss group was 3.6 (interquartile range, 2.0-6.0) kilograms. HRs and 95% CIs for 30-day all-cause mortality, all-cause readmission and HF readmission associated with weight loss were 0.75 (0.63-0.90), 0.90 (0.83-0.99) and 0.83 (0.72-0.96), respectively. Respective 60-day HRs (95% CIs) were 0.80 (0.70-0.92), 0.91 (0.85-0.98) and 0.88 (0.79-0.98). These associations were attenuated and lost significance during 6 months of follow-up. CONCLUSIONS: Among older patients hospitalized for decompensated HF, in-hospital weight loss was associated with a lower risk of mortality and hospital readmission. These findings suggest that in-hospital weight loss, a marker of successful diuresis and decongestion, is also a marker of improved clinical outcomes.

APA Citation

Gill, Gauravpal S.; Lam, Phillip H.; Brar, Vijaywant; Patel, Samir; Arundel, Cherinne; Deedwania, Prakash; Faselis, Charles; Allman, Richard M.; Zhang, Sijian; Morgan, Charity J.; Fonarow, Gregg C.; and Ahmed, Ali, "In-Hospital Weight Loss and Outcomes in Patients With Heart Failure" (2022). GW Authored Works. Paper 1393.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1393

Department

Medicine