Basic laboratory parameters as predictors of in-hospital death in patients with acute decompensated heart failure: data from a large single-centre cohort.

BACKGROUND: Heart failure (HF) is a growing cause of hospitalisation worldwide, and despite significant progress in its treat-ment it is still associated with high mortality. AIM: The aim of this study was to find factors predicting in-hospital death in acute decompensated HF by analysis of basic laboratory data and echocardiography, routinely collected on admission to the hospital. METHODS: To this single-centre retrospective study we involved 638 consecutive patients hospitalised in the years 2007-2008 due to acute decompensated HF. To the initial univariate analysis we included the results of echocardiography and 36 basic laboratory tests performed at hospital admission. Parameters significantly associated with in-hospital death in univariate analysis were taken to multivariate regression analysis. RESULTS: In-hospital death occurred in 119 cases (median age 75 years; 40.3% females). The multivariate analysis revealed sig-nificant association between in-hospital death and: higher leukocyte count (death [D]: 13.5 vs. survival [S]: 8.8 G/L, p < 0.01), higher neutrophil count (D: 10.5 vs. S: 5.9 G/L, p < 0.01), lower lymphocyte count (D: 1.3 vs. S: 1.7 G/L, p < 0.05), higher C-reactive protein concentration (D: 20.8 vs. S: 6.7 mg/dL, p < 0.01), higher serum glucose concentration (D: 167.0 vs. S: 116.0 mg/dL, p < 0.00001), higher serum creatinine concentration (D: 1.5 vs. S: 1.2 mg/dL, p < 0.0001), higher blood urea nitrogen concentration (D: 29.0 vs. S: 22.0 mg/dL, p < 0.00001), and higher aspartate aminotransferase (D: 72.0 vs. S: 27.0 U/L, p < 0.0001). Surprisingly, there was no significant association with echocardiographic parameters. CONCLUSIONS: Analysis of basic laboratory data collected on admission to the hospital may help to identify patients with acute decompensated HF, who are at high risk of in-hospital death.

[Changes in intraocular pressure during pregnancy]. / Zmiany cisnienia wewnatrzgalkowego w przebiegu ciazy.

PURPOSE: The purpose of this study was to define physiological changes in intraocular pressure during pregnancy. MATERIAL AND METHODS: 182 healthy pregnant women were examined cross-sectionally throughout the pregnancy. After measuring systolic and diastolic blood pressure full ophthalmological examination was performed (visual acuity, refractive error, intraocular pressure, slit lamp examination and fundus exam). All subjects were free from any systemic or ocular diseases. RESULTS: Intraocular pressure significantly decreased during successive stages of pregnancy. The results are presented as means SD. In the control group mean IOP was 15.6 +/- 1.81 mmHg. During first ten weeks of pregnancy mean IOP was 15.33 +/- 1.98 mmHg, between 11-20 hbd was 14.52 +/- 2.37 mmHg, between 21-30 hbd was 13.47 +/- 2.19 mmHg, and towards the end of pregnancy (31-40 hbd) was 12.5 +/- 1.96 mmHg. The mean fall of IOP during whole pregnancy was 3.1 +/- 0.38 mmHg (p < 0.001). In these subjects pregnancy decreased IOP by 19.8%. CONCLUSIONS: The study results showed a gradual, statistically significant fall of intraocular pressure during pregnancy.