title: Use of Diuretics is not associated with mortality in patients admitted to the emergency department: results from a cross-sectional study.
abstract: BACKGROUND
  Patients with diuretic therapy are at risk for drug-induced adverse reactions. It is unknown if presence of diuretic therapy at hospital emergency room admission is associated with mortality.
  
  
  METHODS
  In this cross sectional analysis, all emergency room patients 2010 and 2011 at the Inselspital Bern, Switzerland were included. A multivariable logistic regression model was performed to assess the association between pre-existing diuretic medication and 28 day mortality.
  
  
  RESULTS
  Twenty-two thousand two hundred thirty-nine subjects were included in the analysis. A total of 8.5%, 2.5%, and 0.4% of patients used one, two, or three or more diuretics. In univariate analysis spironolactone, torasemide and chlortalidone use were associated with 28 day mortality (all p < 0.05). In a multivariate cox regression model no association with mortality was detectable (p > 0.05). No difference existed between patients with or without diuretic therapy (P > 0.05). Age and creatinine were independent risk factors for mortaliy (both p < 0.05).
  
  
  CONCLUSIONS
  Use of diuretics is not associated with mortality in an unselected cohort of patients presenting in an emergency room.
authors.affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland. Dominikhaider2003@yahoo.de.
authors.forename: Dominik G
authors.initials: DG
authors.lastname: Haider
authors.affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland. Linder.gregor@gmail.com.
authors.forename: Gregor
authors.initials: G
authors.lastname: Lindner
authors.affiliation: Department of Clinical Pharmacology, Medical Universtiy of Vienna, Spitalgasse 23, 1090, Vienna, Austria. Michael.wolzt@meduniwien.ac.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Wolzt
authors.affiliation: Center of Laboratory Medicine, Inselspital, University Hospital Bern, Bern, Switzerland. Alexander.leichtle@insel.ch.
authors.forename: Alexander Benedikt
authors.initials: AB
authors.lastname: Leichtle
authors.affiliation: Center of Laboratory Medicine, Inselspital, University Hospital Bern, Bern, Switzerland. Martin.fiedler@insel.ch.
authors.forename: Georg-Martin
authors.initials: GM
authors.lastname: Fiedler
authors.affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland. Thomas.sauter@insel.ch.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Sauter
authors.affiliation: Department of Intensive Care Medicine, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. v.fuhrmann@uke.de.
authors.forename: Valentin
authors.initials: V
authors.lastname: Fuhrmann
authors.affiliation: Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland. aristomenis.exadaktylos@insel.ch.
authors.forename: Aristomenis K
authors.initials: AK
authors.lastname: Exadaktylos
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000008:administration & dosage* / Q000009:adverse effects; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010343:Patient Admission
chemical_list: D004232:Diuretics
references.citation: Crit Care Med. 2004 Aug;32(8):1669-77
references.pmid: 15286542
references.citation: JAMA. 1992 Feb 26;267(8):1083-9
references.pmid: 1735925
references.citation: Nephrol Dial Transplant. 2005 Nov;20(11):2299-301
references.pmid: 16115842
references.citation: J Clin Hypertens (Greenwich). 2008 Jun;10(6):477-84
references.pmid: 18550938
references.citation: WMJ. 2009 Apr;108(2):109-14
references.pmid: 19437938
references.citation: Am J Med. 2011 Nov;124(11):1064-72
references.pmid: 22017784
references.citation: PLoS One. 2012;7(3):e30836
references.pmid: 22431960
references.citation: BMC Med. 2013;11:83
references.pmid: 23531202
references.citation: J Crit Care. 2014 Feb;29(1):2-9
references.pmid: 24331943
references.citation: J Cardiovasc Pharmacol Ther. 2014 Jan;19(1):5-13
references.pmid: 24243991
references.citation: Curr Hypertens Rep. 2014 Feb;16(2):414
references.pmid: 24407447