Resumo

BARBOSA, Roberto Ramos et al. Hemoglobina e sódio séricos: : marcadores prognósticos precoces na insuficiência cardíaca descompensada. Insuf. card. [online]. 2019, vol.14, n.1, pp.2-6. ISSN 1852-3862.

Background. Acute decompensated heart failure (HF) has high morbidity and mortality. Clinical and laboratory prognostic markers have been identified, although the early influence of serum hemoglobin (Hb) and sodium (Na) is not precisely known. This study aimed to assess the clinical features and outcomes in patients with decompensated HF, according to serum dosage of Hb and Na within the first 24 hours of admission. Material and methods. Prospective observational study that included hospitalized patients with decompensated HF followed for up to 30 days after discharge. Groups were analyzed as follows: normal Hb and Na (group 1), initial Hb < 10.0 mg/dl (group 2), initial Na < 135 mEq/l (group 3), or both alterations (group 4). The primary outcome was in-hospital or 30-days death. Results. From the total 40 patients sample, 37.5% were in group 1, 35.0% group 2, 7.5% group 3, and 20.0% group 4. Average age was 67.2 ±15 vs 66.4 ±13 vs 59.0 ±11 vs 55.7 ±14 (p=0.08). Male subjects were 60.0%, 35.7%, 100% and 62.5% (p=0.08). Outcomes for each respective group were: mortality 6.7% vs 21.4% vs 0% vs 37.5% (p=0.007), 30-days re-admission 6.7% vs 28.6% vs 0% vs 12.5% (p=0.12), acute renal failure 20.0% vs 42.8% vs 33.3% vs 25.0% (p=0.04), invasive mechanical ventilation 13.3% vs 7.1% vs 0% vs 0% (p=0.41), and length of hospitalization 16 ±10 vs 17 ±12 vs 24 ±11 vs 33 ±19 days (p=0.03). Conclusions. In patients with acute decompensated HF, Hb < 10 mg/dl within the first 24 hours of admission was associated to the occurrence of acute renal failure. The combination of Hb < 10 mg/dl and was associated to higher mortality and higher length of hospitalization.

Palavras-chave : Heart failure; Anemia; Hyponatremia; Mortality.

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