Background: Patients with acute heart failure exhibit high rates of early rehospitalization accompanied by significant mortality. Therefore, identifying high-risk patients who are prone to disease exacerbation may enable early therapeutic interventions for improved disease management. Methods: This single-center, prospective observational study was conducted at a Brazilian hospital. Adult patients hospitalized for acute heart failure were enrolled. On the day of hospital discharge, NT-pro-BNP and body weight data were collected, and bedside lung and inferior vena cava ultrasound examinations were performed. The patients were followed up for up to 30 days after discharge. The primary outcome was rehospitalization for acute heart failure. Results: A total of 100 patients were included in the final analysis, of whom 10% were readmitted within 30 days owing to acute heart failure. The number of patients with total B-line scores >3 in the readmitted and non-readmitted groups was 6 and 19, respectively (60% and 21%, respectively; absolute risk difference: 39%; p = 0.014). The mean inferior vena cava collapsibility index was significantly lower in readmitted compared to that in non-readmitted patients (25.5% vs. 39.8%, standard deviation: 15.4% and 18.4%, respectively; p = 0.020). However, mean body weight and mean NT-pro-BNP levels at discharge did not differ between the groups. In a multivariate logistic regression model adjusted for sex, age, discharge body weight, and left ventricular ejection fraction, a total B-lines score >3 had an odds ratio of 4.72 (95% confidence interval (CI): 1.01–22.13; p = 0.049), while the inferior vena cava collapsibility index had an odds ratio of 0.96 (95% CI: 0.91–1.01; p = 0.091). Conclusions: A total B-line score >3 at discharge in patients hospitalized for acute heart failure was associated with 30-day rehospitalization. In contrast, inferior vena cava ultrasound, discharge body weight, and NT-pro-BNP at discharge were not significant predictors of rehospitalization.

SUMMARY OBJECTIVE: The aim of this study was to compare the return of spontaneous circulation and survival to discharge of patients who experienced in-hospital cardiac arrest assisted by a rapid response team during the day versus night and weekdays versus weekends. METHODS: This retrospective observational study was conducted at a tertiary teaching hospital. Patients aged 18 years or older who experienced a cardiac arrest in the wards between March 2018 and December 2021 were included. Patients with an express order of “natural death permission” were excluded. Data regarding the period of in-hospital cardiac arrest occurrence, return of spontaneous circulation, and survival to discharge were collected from medical records. In addition, data related to nursing staff leave were collected. RESULTS: A total of 387 patients were included in the analysis. The mean age was 65.4±14.8 years, and 53.7% were men. In the multivariate logistic regression, in-hospital cardiac arrest during the day versus night was not associated with return of spontaneous circulation. However, in-hospital cardiac arrest during weekdays versus weekends showed a significant association with return of spontaneous circulation (odds ratio=2.073; 95%CI 1.206–3.564; p=0.008). No differences were found in survival to discharge between daytime versus nighttime or weekdays versus weekends. CONCLUSION: There is no difference in return of spontaneous circulation rates between in-hospital cardiac arrest events occurring during the day versus night. However, a significant difference in return of spontaneous circulation rates was observed between weekdays and weekends, although this difference did not extend to in-hospital survival rates.

Background: Upper gastrointestinal bleeding (UGIB) is a significant cause of cirrhosis decompensation; however, there is still controversy on risk factors for poor outcomes. This study aims to explore the impact of additional variables, such as liver disease etiology and intensive care unit (ICU) accessibility, on mortality, rebleeding, and infection rates. Methods: Cox regression analysis was employed to identify predictors associated with mortality and rebleeding, while Poisson regression analysis was utilized to assess associations with infections. Results: A total of 228 patients were included, with the majority classified as Child‐Pugh B and C. Among them, 96 patients (42.1%) had alcohol‐associated liver disease (ALD), of which 45 (46.9%) were in alcohol abstinence. One hundred and ninety‐five patients (85.5%) survived, while 33 (14.5%) died. Intubation was required for 31 patients (13.6%), and 28 were transferred to the ICU. Antibiotic prophylaxis was administered to 219 patients (96%), and 55 (24.1%) developed infections. Both orotracheal intubation and transfusions were associated with high mortality, whereas ALD was linked to a lower risk of death ( p < 0.001, 0.029, and 0.005, respectively). Intubation was also correlated with an increased risk of rebleeding, while transfer to ICU reduced this complication ( p = 0.012 and 0.045, respectively). The Child‐Pugh score and length of hospitalization were associated with the occurrence of infections ( p = 0.037 and < 0.001, respectively). Conclusions: Intubation, transfusions, liver disease etiology, and ICU accessibility are critical predictors following UGIB in cirrhosis. Additionally, the Child‐Pugh score and duration of hospitalization are directly proportional to the risk of infections in this context. Trial Registration: ClinicalTrials.gov identifier: NCT04662918