Basic laboratory parameters as predictors of in-hospital death in patients with acute decompensated heart failure: data from a large single-centre cohort

Background: Heart failure (HF) is a growing cause of hospitalisation worldwide, and despite significant progress in its treat­ment it is still associated with high mortality. Aim: The aim of this study was to find factors predicting in-hospital death in acute decompensated HF by analysis of basic laboratory data and echocardiography, routinely collected on admission to the hospital. Methods: To this single-centre retrospective study we involved 638 consecutive patients hospitalised in the years 2007–2008 due to acute decompensated HF. To the initial univariate analysis we included the results of echocardiography and 36 basic laboratory tests performed at hospital admission. Parameters significantly associated with in-hospital death in univariate analysis were taken to multivariate regression analysis. Results: In-hospital death occurred in 119 cases (median age 75 years; 40.3% females). The multivariate analysis revealed sig­nificant association between in-hospital death and: higher leukocyte count (death [D]: 13.5 vs. survival [S]: 8.8 G/L, p < 0.01), higher neutrophil count (D: 10.5 vs. S: 5.9 G/L, p < 0.01), lower lymphocyte count (D: 1.3 vs. S: 1.7 G/L, p < 0.05), higher C-reactive protein concentration (D: 20.8 vs. S: 6.7 mg/dL, p < 0.01), higher serum glucose concentration (D: 167.0 vs. S: 116.0 mg/dL, p < 0.00001), higher serum creatinine concentration (D: 1.5 vs. S: 1.2 mg/dL, p < 0.0001), higher blood urea nitrogen concentration (D: 29.0 vs. S: 22.0 mg/dL, p < 0.00001), and higher aspartate aminotransferase (D: 72.0 vs. S: 27.0 U/L, p < 0.0001). Surprisingly, there was no significant association with echocardiographic parameters. Conclusions: Analysis of basic laboratory data collected on admission to the hospital may help to identify patients with acute decompensated HF, who are at high risk of in-hospital death.