In-hospital Mortality in Heart Failure Patients with Acute Kidney Injury

Abstract

Objectives: Acute kidney injury (AKI) is frequently present co-morbid condition in patients admitted with acute heart failure (AHF). This study aimed to determine the frequency of in-hospital mortality in AHF patients presenting with AKI.

Methodology: This descriptive case series of AHF patients with AKI was conducted at a tertiary care cardiac hospital in Karachi, Pakistan. In accordance with the “Risk, Injury, Failure, Loss, and End‐Stage Renal Disease (RIFLE) scale," the AKI was defined as a 3.0‐fold increase in serum creatinine (sCr) or sCr > 4.0 mg/dL within 48 hours. All the patients were followed for seven days in order to assess the outcome variable, i.e., in-hospital mortality.

Results: A total of 149 patients were included with a mean age of 59.7 ± 11.03 years, and 80 (53.7%) patients were male. Hypertensive patients were 59.1% (88) of the sample, and 38.9% (58) of the patients were diabetics. In-hospital mortality was found in 11 (7.4%) patients. The mortality rate was 14.1% vs. 2.4%; p=0.008 among patients >60 and 40 to 60 years, respectively. The mortality rate was 12.5% vs. 3.5%; p=0.038 among diabetic and non-diabetic patients. Similarly, the mortality rate was 11.4% vs. 1.6%, p=0.022, among hypertensive and non-hypertensive patients.

Conclusion: It is to conclude that AKI in AHF patients carries a significant burden of in-hospital mortality. The mortality rate was significantly higher for patients with older age and co-morbid conditions such as hypertension and diabetes.