Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Comparison of hand-carried ultrasound assessment of the inferior vena cava and N-terminal pro-brain natriuretic peptide for predicting readmission after hospitalization for acute decompensated heart failure.

Publication ,  Journal Article
Goonewardena, SN; Gemignani, A; Ronan, A; Vasaiwala, S; Blair, J; Brennan, JM; Shah, DP; Spencer, KT
Published in: JACC Cardiovasc Imaging
September 2008

OBJECTIVES: We sought to compare the value of serial assessment with hand-carried ultrasound (HCU) of the inferior vena cava (IVC) with brain natriuretic peptide (BNP) to identify patients with acute decompensated heart failure (ADHF) who will be readmitted or seek emergency department treatment after hospital discharge. BACKGROUND: Congestive heart failure (CHF) is a leading cause for hospitalization and, once hospitalized, patients with CHF frequently are readmitted. To date, no reliable index exists that can be used to predict whether patients with ADHF can be discharged with low readmission likelihood. METHODS: A total of 75 patients who were admitted with a primary diagnosis of ADHF were followed. All patients were assessed at admission and discharge with the use of routine clinical evaluation, BNP measurement, and HCU evaluation of the IVC by physicians with limited training in ultrasound. RESULTS: During the 30-day follow-up, 31 patients were rehospitalized or presented to the emergency department. Patients who were subsequently readmitted could not be differentiated from those who were not readmitted by their demographics, comorbidities, vital signs, presence of symptoms/signs suggestive of persistent congestion, hospital length of stay, or net volume removal. Routine laboratory tests, including assessment of renal function, also failed to predict readmission with the exception of serum sodium. Although admission BNP was similar in patients readmitted and not readmitted, pre-discharge log-transformed BNP was greater in patients who subsequently were readmitted. Patients who required repeat hospitalization had a larger IVC size on admission as well as at discharge. In addition, patients who were readmitted had persistently plethoric IVCs with lower IVC collapsibility indexes. At discharge, only serum sodium, log-transformed BNP, IVC size, and collapsibility were statistically significant predictors of readmission. CONCLUSIONS: This study confirms that, once hospitalized, patients with CHF frequently are readmitted. Bedside evaluation of the IVC with a HCU device at the time of admission and discharge, as well as pre-discharge BNP, identified patients admitted with ADHF who were more likely to be readmitted to the hospital.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JACC Cardiovasc Imaging

DOI

EISSN

1876-7591

Publication Date

September 2008

Volume

1

Issue

5

Start / End Page

595 / 601

Location

United States

Related Subject Headings

  • Vena Cava, Inferior
  • Ultrasonography
  • Treatment Outcome
  • Time Factors
  • Risk Assessment
  • Recurrence
  • Prospective Studies
  • Predictive Value of Tests
  • Point-of-Care Systems
  • Peptide Fragments
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Goonewardena, S. N., Gemignani, A., Ronan, A., Vasaiwala, S., Blair, J., Brennan, J. M., … Spencer, K. T. (2008). Comparison of hand-carried ultrasound assessment of the inferior vena cava and N-terminal pro-brain natriuretic peptide for predicting readmission after hospitalization for acute decompensated heart failure. JACC Cardiovasc Imaging, 1(5), 595–601. https://doi.org/10.1016/j.jcmg.2008.06.005
Goonewardena, Sascha N., Anthony Gemignani, Adam Ronan, Samip Vasaiwala, John Blair, J Matthew Brennan, Dipak P. Shah, and Kirk T. Spencer. “Comparison of hand-carried ultrasound assessment of the inferior vena cava and N-terminal pro-brain natriuretic peptide for predicting readmission after hospitalization for acute decompensated heart failure.JACC Cardiovasc Imaging 1, no. 5 (September 2008): 595–601. https://doi.org/10.1016/j.jcmg.2008.06.005.
Goonewardena, Sascha N., et al. “Comparison of hand-carried ultrasound assessment of the inferior vena cava and N-terminal pro-brain natriuretic peptide for predicting readmission after hospitalization for acute decompensated heart failure.JACC Cardiovasc Imaging, vol. 1, no. 5, Sept. 2008, pp. 595–601. Pubmed, doi:10.1016/j.jcmg.2008.06.005.
Goonewardena SN, Gemignani A, Ronan A, Vasaiwala S, Blair J, Brennan JM, Shah DP, Spencer KT. Comparison of hand-carried ultrasound assessment of the inferior vena cava and N-terminal pro-brain natriuretic peptide for predicting readmission after hospitalization for acute decompensated heart failure. JACC Cardiovasc Imaging. 2008 Sep;1(5):595–601.
Journal cover image

Published In

JACC Cardiovasc Imaging

DOI

EISSN

1876-7591

Publication Date

September 2008

Volume

1

Issue

5

Start / End Page

595 / 601

Location

United States

Related Subject Headings

  • Vena Cava, Inferior
  • Ultrasonography
  • Treatment Outcome
  • Time Factors
  • Risk Assessment
  • Recurrence
  • Prospective Studies
  • Predictive Value of Tests
  • Point-of-Care Systems
  • Peptide Fragments