Mortality Rates Double With Fluid Imbalance in Heart Failure with Major Complications Patients at Large South Carolina Hospitals

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In Fluid Imbalance

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By: James Pitt  Jul. 27, 2018

Heart failure causes patients to retain fluids: the heart can no longer pump with enough strength to move large volumes efficiently. This is why patients with heart failure should avoid too much fluid or salt intake.

Excess fluid strongly associates with mortality in congestive heart failure. Louw et. al (2014) found that patients in the quartile with highest fluid balance (i.e. fluid overload) were 83% more likely to die within 90 days than patients in the quartile with lowest fluid balance.

Dexur analysts examined the association of mortality in heart failure with fluid imbalances including volume overload, edema, hyponatremia, and other conditions. The sample used six hospitals in South Carolina with more than 8,000 Medicare-eligible inpatient discharges per year.

At all six hospitals, in-hospital mortality in patients with heart failure and shock with major complications/ comorbidities (DRG 291) was much higher in patients with fluid imbalances than patients without fluid imbalances.

In-hospital mortality in DRG 291 with fluid imbalance was highest at Medical University of South Carolina Hospital (Charleston, SC), at 17%. The lowest in-hospital mortality in DRG 291 with fluid imbalance was 8%, at Greenville Memorial Hospital (Greenville, SC). In-hospital mortality in DRG 291 without fluid imbalance was slightly lower at McLeod Regional Medical Center (Florence, SC), at 3%.

Fluid overload can involve changes in fluid distribution, not just increased volume. Cotter et. al (2014) studied why pulmonary congestion (fluid overload around the lungs) can occur in patients who have not gained much weight (and therefore cannot have gained much fluid volume). Cotter et. al concluded that vascular stiffness and reduced cardiac function redistribute fluid to the lungs.

DEXUR PRO MEMBERS GET ACCESS TO:

1. Total DRG Discharges
2. Total Fluid Imbalance Discharges at DRG
3. % of Fluid Imbalance Discharges at DRG
4. Mortality Rates at DRG
5. Mortality Rates without Fluid Imbalance
6. Mortality Rates with Fluid Imbalance
7. Difference in Mortality Rates with & without Fluid Imbalance
8. State Difference in Mortality Rates with & without Fluid Imbalance
9. National Difference in Mortality Rates with & without Fluid Imbalance

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For patients with DRG 291 (HEART FAILURE & SHOCK W MCC) at the following hospitals:

1. McLeod Regional Medical Center (Florence, SC)
2. Medical University Of South Carolina Hospital (Charleston, SC)
3. Spartanburg Medical Center (Spartanburg, SC)
4. Greenville Memorial Hospital (Greenville, SC)
5. Grand Strand Medical Center (Myrtle Beach, SC)
6. Lexington Medical Center (West Columbia, SC)

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