Admission inferior vena cava measurements are associated with mortality after hospitalization for acute decompensated heart failure.
Prognostication of patients hospitalized with acute decompensated heart failure (ADHF) is important to patients, providers, and healthcare systems. Few bedside tools exist to prognosticate patients hospitalized with ADHF.



The objective of this study was to assess the relationship between inferior vena cava (IVC) diameter and postdischarge mortality in patients hospitalized with ADHF.



Prospective observational study.



A 247-bed urban teaching hospital in Spain PATIENTS: Ninety-seven patients hospitalized with ADHF.



None.



The IVC diameter and collapsibility were measured by a hospitalist at the time of admission and discharge. Primary outcome was 90-day all-cause mortality. Secondary outcomes were readmission rates at 90 and 180 days, and 180-day all-cause mortality. Patients were followed for 180 days.



Data from 80 patients were analyzed. From admission to discharge, a significant improvement in IVC maximum (IVCmax) diameter (2.12 vs 1.87 cm; P < 0.001) and IVC collapsibility (25.7% vs 33.1%; P < 0.001) was seen in the total study cohort. During the 90-day follow-up period, 11 patients (13.7%) died. An admission IVCmaxdiameter ≥1.9 cm was associated with a higher mortality rate at 90 days (25.4% vs 3.4%; P = 0.009) and 180 days (29.3% vs 3.4%; P = .003). In a multivariate Cox proportional hazards regression analysis, admission IVCmaxdiameter was an independent predictor of 90-day mortality (hazard ratio [HR]: 5.88; 95% confidence interval [CI]: 1.21-28.10; P = 0.025) and 90-day readmission (HR: 3.20; 95% CI: 1.24-8.21; P = 0.016).



In patients hospitalized with acute decompensated heart failure, a dilated IVC by bedside ultrasound at the time of admission is associated with a higher 90-day mortality after hospitalization. Journal of Hospital Medicine 2016;11:778-784. © 2016 Society of Hospital Medicine.
Department of Internal Medicine and Emergency Medicine, Infanta Cristina University Hospital, Madrid, Spain.|Department of Medicine, Complutense University, Madrid, Spain.
Pilar
P
Cubo-Romano
Department of Internal Medicine and Emergency Medicine, Infanta Cristina University Hospital, Madrid, Spain.|Department of Medicine, Complutense University, Madrid, Spain.
Juan
J
Torres-Macho
Section of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, Texas. sonin@uthscsa.edu.|Division of Hospital Medicine, University of Texas School of Medicine in San Antonio, Texas. sonin@uthscsa.edu.
Nilam J
NJ
Soni
Section of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, Texas.
Luis F
LF
Reyes
Department of Medicine, Complutense University, Madrid, Spain.|Department of Cardiology, Infanta Cristina University Hospital, Madrid, Spain.
Ana
A
Rodríguez-Almodóvar
Department of Biochemistry, Infanta Cristina University Hospital, Madrid, Spain.
Juan Manuel
JM
Fernández-Alonso
Department of Medicine, Complutense University, Madrid, Spain.|Department of Cardiology, Infanta Cristina University Hospital, Madrid, Spain.
Rosa
R
González-Davia
Department of Internal Medicine and Emergency Medicine, Infanta Cristina University Hospital, Madrid, Spain.|Department of Medicine, Complutense University, Madrid, Spain.
José Manuel
JM
Casas-Rojo
Section of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, Texas.
Marcos I
MI
Restrepo
Department of Internal Medicine and Emergency Medicine, Infanta Cristina University Hospital, Madrid, Spain.|Department of Medicine, Complutense University, Madrid, Spain.
Gonzalo García
GG
de Casasola
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D008297:Male; D010359:Patient Readmission; D011446:Prospective Studies; D013030:Spain; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods / Q000706:statistics & numerical data*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*