Association of estimated glomerular filtration rate and in-hospital mortality in patients hospitalized for heart failure: a retrospective cohort study - Summary - MDSpire
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Association of estimated glomerular filtration rate and in-hospital mortality in patients hospitalized for heart failure: a retrospective cohort study
To quantify the independent prognostic impact of eGFR on the risk of in-hospital mortality in heart failure patients and characterize its underlying nonlinear relationship.
Key Findings:
In-hospital mortality rates increased progressively across eGFR strata: 5.77%, 6.37%, 8.19%, 11.72%, and 10.93%.
eGFR 45–59 and 30–44 mL/min/1.73 m2 were independently associated with higher in-hospital mortality risk (OR 1.27 and OR 1.36, respectively).
Patients with eGFR < 60 mL/min/1.73 m2 had a 37% higher risk of in-hospital mortality (OR 1.37).
Significant interaction between eGFR and NYHA functional class was observed, with amplified risk in classes III (OR 1.75) and IV (OR 2.13).
Nonlinear association between eGFR and in-hospital mortality risk was identified, with a critical inflection point at approximately 60 mL/min/1.73 m2.
Interpretation:
Reduced eGFR is associated with in-hospital mortality in heart failure patients, particularly in those with advanced NYHA classes.
Limitations:
The study is retrospective and may be subject to biases inherent in such designs.
Patients with advanced CKD (eGFR < 30 mL/min/1.73 m2) are often excluded from randomized clinical trials, limiting generalizability.
Conclusion:
The findings highlight the association between eGFR and in-hospital mortality in heart failure patients.
