{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:45:08Z","timestamp":1782992708333,"version":"3.54.5"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Little is known about the initial dosing of loop diuretics among patients hospitalized for heart failure and its association with outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We identified patients admitted for heart failure at 24 hospitals across two health systems between January 1, 2017, and December 31, 2020. Initial diuretic dose was categorized relative to home dose in furosemide equivalents. The primary outcomes (length of stay) and secondary outcomes (rates of acute kidney injury, in\u2010hospital mortality, and 30\u2010day readmissions) were compared across categories of initial diuretic dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 14\u2009332 patients admitted for heart failure, the initial diuretic dose was lower\u2010than\u2010home dose in 1866 (13.0%) patients, equivalent\u2010to\u2010home dose in 3171 (22.1%) patients, and higher\u2010than\u2010home dose in 9295 (64.9%) patients. Compared with patients who received an equivalent or higher initial diuretic dose relative to home dose, risk\u2010adjusted length of stay was longer among patients receiving a lower dose (4.9\u2009days versus 4.0\u2009days versus 4.0\u2009days,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.01). Compared with equivalent\u2010to\u2010home dose, a higher initial diuretic dose was associated with a higher risk\u2010adjusted rate of acute kidney injury (incident risk ratio [IRR], 1.17 [95% CI 1.04\u20131.31];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.009) and a lower risk of 30\u2010day readmission (IRR, 0.85 [95% CI, 0.78\u20130.93];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In a cohort of patients admitted for heart failure, more than 1 in 3 patients received an initial dose of intravenous loop diuretics that was lower than or equivalent to their home diuretic dose, and the initial dose was associated with length of hospital stay and acute kidney injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.038783","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T10:18:53Z","timestamp":1772187533000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cohort Study of Initial Diuretic Dosing and Outcomes Among Patients Hospitalized for Congestive Heart Failure: Insights From the Cardiovascular Quality Improvement and Care Innovation Consortium"],"prefix":"10.1161","volume":"15","author":[{"given":"Naureen","family":"Qadri","sequence":"first","affiliation":[{"name":"Minneapolis Heart Institute Foundation","place":["Minneapolis, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Kwok","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute Foundation","place":["Minneapolis, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"Stanberry","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute Foundation","place":["Minneapolis, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsey","family":"Thomas","sequence":"additional","affiliation":[{"name":"Health Catalyst","place":["Minneapolis, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie J.","family":"Irausquin","sequence":"additional","affiliation":[{"name":"Atrium Health","place":["Charlotte, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya","family":"Gupta","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph E.","family":"Ebinger","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Medical Center","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ty J.","family":"Gluckman","sequence":"additional","affiliation":[{"name":"Providence Heart Institute","place":["Portland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Kannan","family":"Mutharasan","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine","place":["Chicago, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinav","family":"Goyal","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas K.","family":"Brownell","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin M.","family":"Scirica","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital and Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Michael","family":"Ho","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine","place":["Aurora, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep R.","family":"Das","sequence":"additional","affiliation":[{"name":"Allina Health Minneapolis Heart Institute","place":["Minneapolis, USA"]},{"name":"University of Texas Southwestern Medical Center","place":["Dallas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Downey","sequence":"additional","affiliation":[{"name":"Atrium Health","place":["Charlotte, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Bradley","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute Foundation","place":["Minneapolis, USA"]},{"name":"University of Texas Southwestern Medical Center","place":["Dallas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000164149"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1703100"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1005419"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.019"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/20009666.2018.1503916"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2003.08.012"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2007.07.011"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.120.006753"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc5713"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2024.101250"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2203094"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac689"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.038783","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:08:45Z","timestamp":1782990525000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.038783"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,3,17]]}},"alternative-id":["10.1161\/JAHA.124.038783"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.038783","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"2026-02-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e038783"}}