Table 3.
Risk of death associated with loop diuretic dose, net fluid output, and diuretic efficiency in the Penn and ESCAPE cohorts
| Univariable | Multivariable | Multivariable with Adjustment for Baseline Characteristics | |||||
|---|---|---|---|---|---|---|---|
| HR (95% CI) | p Value | HR (95% CI) | P Value | HR (95% CI) | P Value | ||
| Penn Cohort (Cumulative diuretic efficiency) | Loop diuretic† | 1.56 (1.26–1.93) | <0.001* | 1.36 (1.05–1.76) | 0.021* | 1.24 (0.94–1.64) | 0.13 |
| Net fluid output† | 1.01 (0.82–1.25) | 0.93 | 1.04 (0.80–1.34) | 0.78 | 0.96 (0.74–1.26) | 0.78 | |
| Diuretic efficiency† | 1.64 (1.32–2.03) | <0.001* | 1.51 (1.17–1.95) | 0.002* | 1.36 (1.04–1.78) | 0.023* | |
| Penn Cohort (Peak diuretic efficiency) | Loop diuretic† | 1.56 (1.26–1.93) | <0.001* | 1.41 (1.11–1.79) | 0.005* | 1.25 (0.97–1.62) | 0.073 |
| Net fluid output† | 1.01 (0.82–1.25) | 0.93 | 1.08 (0.84–1.39) | 0.54 | 0.96 (0.74–1.25) | 0.78 | |
| Diuretic efficiency† | 1.70 (1.38–2.11) | <0.001* | 1.67 (1.31–2.18) | <0.001* | 1.39 (1.08–1.77) | 0.007* | |
| ESCAPE Cohort (Peak diuretic efficiency) | Loop diuretic† | 2.46 (1.54–3.94) | <0.001* | 1.68 (0.98–2.88) | 0.059 | 1.32 (0.72–2.40) | 0.37 |
| Net fluid output† | 0.96 (0.61–1.51) | 0.86 | 0.91 (0.54–1.51) | 0.71 | 1.17 (0.66–2.09) | 0.59 | |
| Diuretic efficiency† | 3.98 (2.32–6.84) | <0.001* | 3.47 (1.97–6.24) | <0.001* | 2.86 (1.53–5.36) | 0.001* | |
HR: Hazard ratio, CI: Confidence interval.
To facilitate comparison of effect sizes, hazard ratios represent the risk for all-cause mortality associated with a value above or below the median with the HR reflecting an exposure of diuretic dose above the median, efficiency below the median or fluid output below the median.
In the Penn cohort, variables entered in the multivariable model consisted of: age, race, diabetes, ischemic heart failure etiology, presence of edema, digoxin use, outpatient loop diuretic dose, thiazide diuretic use, heart rate, B-type natriuretic peptide, systolic blood pressure, serum sodium, hemoglobin, eGFR, and blood urea nitrogen. In the ESCAPE cohort these variables were: age, hypertension, ischemic heart failure etiology, presence of edema, jugular venous distension, baseline beta blocker use, baseline angiotensin converting enzyme or receptor blocker use, outpatient loop diuretic dose, thiazide diuretic use, systolic blood pressure, serum sodium, eGFR, blood urea nitrogen and hemoglobin.