On admission serum sodium and uric acid levels predict 30 day rehospitalization or death in patients with acute decompensated heart failure.

AIMS: A considerable proportion of hospitalized patients for acute decompensated heart failure will be readmitted or die in short-term follow-up. In the present study, we aimed to assess the role of admission sodium (Na) and uric acid (UA) levels in the prediction of 30 day post-discharge heart failure readmission or all-cause mortality in advanced heart failure patients admitted with acute decompensation.

METHODS AND RESULTS: One hundred and forty consecutive advanced heart failure patients who were admitted for a recent cardiac decompensation were enrolled in this prospective study. Serum Na and UA levels remained statistically unchanged during index admission ( P  = 0. 54 and 0.19, respectively). Within 30 days post-discharge, composite end point of heart failure rehospitalization or all-cause death occurred in 62 (44.3%) patients (event group). Length of stay was statistically similar between patients in the event and non-event groups ( P  = 0.38). No correlations were also found between length of stay and left ventricular ejection fraction, serum Na, UA, erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), creatinine, and N-terminal pro b-type natriuretic peptide (NT-proBNP) levels (all P  > 0.05). Lower left ventricular ejection fraction and Na and higher UA on admission were significantly associated with 30 day event both in univariate and multivariate analyses.

CONCLUSIONS: Given the predictive role of baseline Na and UA for early post-discharge outcome and the absence of significant changes in their levels during initial hospitalization, admission Na and UA can be considered as prognosticators of acute decompensated heart failure, which their prognostic significance cannot be affected by routine acute heart failure therapy.