The Relationship Between the Utilization of Arterial Blood Gas Analysis and Rehospitalization in Heart Failure: A Retrospective Cohort Study

Abstract

Background: The most common presentation of decompensated HF is dyspnea, and arterial blood gas analysis is an excellent tool for the decision-making process for most dyspneic patients. However, data on the prognostic value of ABG in HF patients are limited. Herein, a retrospective cohort study was conducted to investigate whether the utilization of arterial blood gas analysis was independently associated with re-hospitalization in patients with heart failure. Methods: As a retrospective cohort study, the relevant clinical data of hospitalized patients admitted to Zigong Fourth People's Hospital, Sichuan, China from December 2016 to June 2019 with a diagnosis of HF were analyzed. The re-hospitalization within 6 months and the use of intravenous diuretic, nitrates, inotropes, or vasopressors were compared between patients with and without arterial blood gas analysis. We used a multivariable logistic regression model, propensity score analysis, and an inverse probability-weighting model to ensure the robustness of our findings. Results: We included 1,605 patients with heart failure. The overall re-hospitalization rate within 6 months was 38.2%; it was 34.8% and 41.8% for heart failure patients with or without arterial blood gas analysis, respectively. In the inverse probability-weighting model, the use of arterial blood gas analysis was associated with a 26% lower re-hospitalization rate within 6 months. Conclusion: The performance of arterial blood gas analysis is associated with a 6-month rehospitalization rate benefit in a general population of heart failure patients. This association warrants further investigation.