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Significance of bacteriuria and leukocyturia in the outpatients with heart failure
A Kucukbayrak1, T Tas, E Kemahli
1Department of Infectious Diseases and Clinical Microbiology, Izzet Baysal Medical Faculty, Bolu, Turkey. abdulbayrak@yahoo.com
Insights
Elevated white blood cell counts in urine indicate more severe heart failure (HF) and predict hospitalization. Leukocyturia may signal decompensation in HF patients.
Area of Science:
- Cardiology
- Nephrology
- Infectious Diseases
Background:
- Heart failure (HF) is a complex condition often requiring hospitalization.
- Identifying reliable indicators of HF severity and decompensation is crucial for patient management.
Purpose of the Study:
- To examine the association between illness severity and hospitalization in heart failure patients.
- To investigate the role of leukocyturia and bacteriuria as potential biomarkers in heart failure.
Main Methods:
- A cohort of 403 outpatients diagnosed with heart failure was analyzed.
- Patients were stratified into decompensated (NYHA class 3-4) and compensated (NYHA class 1-2) groups.
- Urinalysis, including leukocyte count, and other clinical assessments were performed.
Main Results:
- Hospitalized heart failure patients exhibited significantly higher mean leukocyte counts in urine compared to non-hospitalized patients.
- A moderate positive correlation was observed between mean leukocyte count and NYHA class (r = 0.526, p < 0.000).
- Urinary leukocyte count > or = 5 cells/mm³ demonstrated 76.1% sensitivity and 75.7% specificity for predicting hospitalization (AUC = 0.825).
Conclusions:
- Leukocyturia, indicated by elevated urinary white blood cell counts, is significantly associated with increased illness severity and hospitalization risk in heart failure patients.
- Urinary white blood cell count serves as a potential indicator for detecting decompensation in heart failure.
- Leukocyturia may be a valuable, non-invasive biomarker in the management of heart failure.
Aim:
To investigate the relationship between severity of illness and hospitalization with the presence of leukocyturia and bacteriuria in outpatients with heart failure (HF).
Patients And Methods:
Four hundred three patients admitted with the diagnosis of HF to cardiology outpatient clinic were included in this study. According to New York Heart Association (NYHA) classification, the patients were divided into two groups to be group A (decompensated) as stage 3 or 4 and group B as stage 1 or 2 (compensated HF). All subjects underwent standard 12-lead ECG and echocardiography. In all patients, full blood, biochemical tests as liver and kidney function tests, full urinary analysis (FUA) and thyroid function tests were analyzed. Mid-stream urine for culture was taken for the leukocytes number > or =5 mm3.
Results:
The mean leukocyte number (MLN) in urine of patients was 16.56 +/- 13.63 in Group A and was 3.74 +/- 5.31 in Group B (p < 0.000). The moderately positive correlation was found between the MLN and NHYA class in all patients (r = 0.526; p < 0.000). In receiver operating characteristic (ROC) curve analysis, the optimal cut-off value of leukocytes in urinalysis to predict hospitalization of CHF was > or =5, with 76.1% sensitivity and 75.7% specificity (area under the curve 0.825, 95% confidence interval 0.781 to 0.862, p = 0.000).
Conclusions:
We found that the numbers of leukocytes in urinalysis of hospitalized patients with HF were significantly higher than non-hospitalized persons. Also, number of leukocyte in urinalysis was positively correlated with NYHA class of HF patients. Namely, leukocyturia may be an indicator of decompensations in HF patients.
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