Factors influencing the dose of loop diuretics in patients with systolic heart failure at discharge from the hospital

摘要

Aim. Systolic heart failure (HF) is a chronic disease, associated with use of many drugs. Diuretics, particularly loop diuretics, are frequently prescribed to patients hospitalized with HF, and kept thereafter. However, diuretics are a group of drugs, which do not provide mortality benefit in HF, and, may bring about some risks, except in a specific group. Hence, it is important to understand the reasons driving physicians to use them. We retrospectively reviewed the hospital discharge records of HF patients. Methods. 700 patients with systolic HF were reviewed. Loop diuretic, furosemide, dose at disharge was classified into two categories as moderate-high (>40 mg/day) and low doses. Results. 613 patients were prescribed furosemide at discharge. Poor functional capacity (FC) (NYHA FC III-IV) at discharge (B=1.894), serum creatinine levels (B=1.567), and spironolactone prescription (B=2.427) were found to be independently associated with moderate-high dose of furosemide prescription during discharge. Conclusion. Diuretics are inevitable in systolic HF. Reasons driving the physicians to prescribe higher doses might be important in drawing pathways towards lower risks.