Objective: Hypoproteinemia is common in patients with acute heart failure, especially in the intensive care unit (ICU). We assessed short-term mortality in patients with acute heart failure for albumin and nonalbumin users. Methods: Our study was a retrospective, observational and single-center study. We included patients with acute heart failure from the Medical Information Mart for Intensive Care-IV and compared short-term mortality and length of hospital stay in patients with and without albumin use. We used propensity score matching (PSM) to adjust for confounders, a multivariate Cox proportional hazard regression model, and performed subgroup analysis. Results: We enrolled 1706 patients with acute heart failure (318 albumin users and 1388 nonalbumin users). The 30-day overall mortality rate was 15.1% (258/1706). After PSM, the 30-day overall mortality was 22.9% (67/292) in the nonalbumin group and 13.7% (40/292) in the albumin group. In the Cox regression model, after propensity matching, the albumin use group was associated with a 47% reduction in 30-day overall mortality [hazard ratio (HR) = 0.53, 95% confidence interval (CI): 0.36–0.78, P = 0.001]. In subgroup analysis, the association was more significant in males, patients with heart failure with reduced ejection fraction (HFrEF), and nonsepsis patients. Conclusion: In conclusion, our investigation suggests that the use of albumin was associated with lower 30-day mortality in patients with acute heart failure, especially in males, those aged >75 years, those with HFrEF, those with higher N-terminal pro-brain natriuretic peptide levels, and those without sepsis.

Objective: To explore the association between hypochloremia and mortality in critically ill patients with chronic heart failure (CHF). Methods: This is a retrospective cohort study from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database of patients with CHF diagnosed according to ICD-9 or ICD-10. Patients were divided into three groups according to serum chloride values. A multivariable logistic regression analysis was used to investigate the relationship between hypochloremia and short-term mortality. Results: A total of 2103 patients with CHF were enrolled in our study. The 30-day mortality was 6.7%. After adjusting for confounders, the 30-day mortality risks of the hypochloremia group were significantly higher than that of the group with normal serum chloride (OR 2.23, 95% CI 1.27–3.92, p = 0.005). Hypochloremia was consistently associated with increased mortality in patients that were older or had sepsis. Conclusion: Hypochloremia is associated with increased mortality in intensive care patients critically ill with CHF.