Diuretic Intensity Score and Mortality in Hospitalized Heart Failure Patients: A Multicenter Propensity-Matched Analysis

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2026-06-19 DOI:10.1002/clc.70386

Jianwei Zhou

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Abstract

Aims

To develop and evaluate a novel Diuretic Intensity Score (DIS) and investigate its relationship with mortality in hospitalized heart failure patients.

Methods

We analyzed propensity-matched data from two independent cohorts: MIMIC-IV (n = 15 942) and the China Regional Heart Failure Database (n = 1884). DIS was calculated based on diuretic types, routes, and combinations. Primary and secondary outcomes were 28- and 90-day all-cause mortality.

Results

Higher DIS was significantly associated with reduced 28-day mortality (Severe vs. Mild: HR 0.27, p < 0.001 in MIMIC-IV; HR 0.10, p < 0.001 in Chinese cohort) and 90-day mortality. Restricted cubic spline analysis revealed an inverse, non-linear relationship, with mortality risk decreasing as intensity increased and then plateauing.

Conclusions

In this propensity-matched analysis of two independent cohorts, a higher DIS was associated with lower 28- and 90-day all-cause mortality in hospitalized heart failure patients. Given the observational design, these findings should be regarded as hypothesis-generating associations rather than evidence of a causal benefit and require confirmation in prospective randomized trials before any change in clinical practice can be recommended.

Abstract Image

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住院心力衰竭患者的利尿强度评分和死亡率：一项多中心倾向匹配分析

目的：建立并评价一种新型利尿强度评分（DIS），并探讨其与住院心力衰竭患者死亡率的关系。方法：我们分析了来自两个独立队列的倾向匹配数据：MIMIC-IV （n = 15942）和中国区域心力衰竭数据库（n = 1884）。DIS是根据利尿剂的种类、途径和组合来计算的。主要和次要结局是28天和90天的全因死亡率。结果：较高的DIS与降低28天死亡率显著相关（重度与轻度：HR 0.27, p）。结论：在两个独立队列的倾向匹配分析中，住院心力衰竭患者较高的DIS与较低的28天和90天全因死亡率相关。考虑到观察性设计，这些发现应被视为产生假设的关联，而不是因果益处的证据，在推荐临床实践中的任何改变之前，需要在前瞻性随机试验中进行确认。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.