Background/Objectives: Body surface area is one of the most important anthropometric parameters in medicine. The study’s primary objective is to compare the consistency of the BSA estimation results through applying available formulas. Other objectives include determining the ability of these formulas to discriminate between death and survival in patients, comparing the formulas’ diagnostic features, and investigating whether the risk associated with a low BSA is independent of BMI. Methods: This study included 1029 patients (median age, 54 years; female, 13.7%; NYHA I/II/III/IV, 6.3%/36.5%/47.7%/9.5%) diagnosed with heart failure. For each patient, BSA was calculated using 25 formulas. Over the 3-year observation period, 31.2% of the patients died. Results: The average BSA value of the optimal discrimination thresholds was 1.79 m² ± 0.084 m² and the BSA difference between the estimators with the lowest (BSA_Meeh1879) and the highest (BSA_Nwoye1989) optimal discrimination thresholds was 0.42 m². The lowest mortality rate was 35.2% and occurred in the subgroup of individuals with BSA values below the optimal discrimination threshold using the BSA_Schlich2010 estimator. The highest mortality was predicted when the estimator BSA_Meeh1879 or BSA_{Livingston&Lee2001} was used. Conclusions: Our study showed a relatively good concordance of 25 BSA estimators in BSA assessment in patients, without extremes of weight or height being known to disrupt it. All BSA estimators presented a significant, although weak, ability to discriminate death from survival at 3-year follow-up; however, BSA is not a very good predictor of HF mortality at 3 years. The higher risk of death in smaller patients, as shown by BSA, was independent of BMI in all but two BSA estimators.

Background and Objectives: Digoxin is a pharmacological agent of natural origin that is still occasionally administered in the intensive care unit (ICU). The objective of this study was to assess the efficacy of routine therapeutic drug monitoring (TDM) of digoxin in ICU patients with heart failure. Materials and Methods: This retrospective, single-center study was conducted using data from the ICU database of the Silesian Center for Heart Diseases in Zabrze, Poland. A total of 980 ICU admissions between January 2018 and July 2023 were screened, and 103 patients met the inclusion criteria. Patients were excluded if they had not received digoxin during hospitalization, had only one digoxin level measurement, or did not meet the established criteria for heart failure. Results: Women required significantly lower doses of digoxin compared to men (0.171 ± 0.053 mg vs. 0.224 ± 0.080 mg; p < 0.001). Patients who died had significantly higher serum digoxin concentrations than survivors (1.33 ± 0.59 ng/mL vs. 1.03 ± 0.43 ng/mL; p = 0.003). Similarly, patients with liver failure had higher digoxin levels compared to those without liver dysfunction (1.31 ± 0.58 ng/mL vs. 1.06 ± 0.46 ng/mL; p = 0.016). A weak negative correlation was found between age and the administered dose (r = −0.20; p = 0.048), and a weak positive correlation was observed between serum digoxin concentration and NT-proBNP levels (r = 0.23; p = 0.048). Conclusions: Among ICU patients with multi-organ failure, those with concomitant liver dysfunction tended to reach higher serum digoxin concentrations. Routine therapeutic drug monitoring of digoxin in ICU patients appears beneficial and may help to optimize dosing and reduce adverse effects.

Background/Objectives: Body surface area is one of the most important anthropometric parameters in medicine. The study's primary objective is to compare the consistency of the BSA estimation results through applying available formulas. Other objectives include determining the ability of these formulas to discriminate between the deaths and living patients, comparing the formulas’ diagnostic features as well as investigating whether the risk associated with a low BSA is independent of BMI. Methods: The study included 1029 patients (median age: 54 years, female: 13.7%, NYHA I/II/III/IV: 6.3% / 36.5% / 47.7% / 9.5%) diagnosed with heart failure. For each patient, BSA was calculated using the 25 formulas. Over the 3-year observation period, 31.2% of the patients died. Results: The average BSA value of the optimal discrimination thresholds was 1.79 m2 ± 0.084 m2 and the BSA difference between the estimators with the lowest (BSAMeeh1879) and the highest (BSANwoye1989) optimal discrimination thresholds was 0.42 m2. The lowest mortality rate was 35.2% and occurred in the subgroup of individuals with BSA values below the optimal discrimination threshold using the BSASchlich2010 estimator. The highest mortality was observed when estimators BSAMeeh1879 or BSALivingston&Lee2001 were used. Conclusions: Our study has shown a relatively good concordance of 25 BSA estimators in BSA assessment in patients, without extremes of weight or height known to disrupt it. All BSA estimators presented a significant, although weak, ability to discriminate death from alive in 3-year follow-up. The higher risk of death in smaller patients as shown by BSA was independent of BMI in all but 2 BSA estimators.