Trajectory of thirst intensity and distress from admission to 4-weeks follow up at home in patients with heart failure

Abstract

BackgroundPatients with heart failure (HF) can suffer from increased thirst intensity and distress. Trajectories of thirst intensity and distress from hospital to home are unclear. The aim of this study was to describe thirst intensity and distress trajectories in patients from the time of hospital admission to 4 weeks after discharge, and describe trajectories of thirst intensity and distress by patients’ characteristics (gender, age, body mass index [BMI], plasma urea, anxiety, and depression).Patients and methodsIn this observational study, data were collected from patients with HF (n=30) at hospital admission, discharge, and at 2 and 4 weeks after discharge. Thirst intensity (visual analog scale, 100 mm) and distress (Thirst Distress Scale-HF, score 9–45) were used. Trajectories were examined using growth modeling.ResultsTrajectory of the thirst intensity was significantly different, for patients with low and high thirst intensity levels (median cut-off 39 mm), from admission to 4 weeks follow up (thirst increased and decreased, respectively). Patients with high level of thirst distress (median score >22) at admission, having fluid restriction and women continued to have higher thirst distress over time. Patients feeling depressed had higher thirst intensity over time. There were no differences in the trajectories of thirst intensity and distress by age, BMI, plasma urea, and anxiety.ConclusionIntensity and distress of thirst, having fluid restriction, and feeling depressed at the admission were critical in predicting the trajectory of thirst intensity and distress after discharge to home in patients with HF. Effective intervention relieving thirst should be provided before their discharge to home.

Thirst and factors associated with frequent thirst in patients with heart failure in Spain

“…Gender and depression have previously been described. 4,8 Medical treatment can induce thirst in some patients and is a known side-effect of diuretics, which was also confirmed in this study. 3 Unexpectedly, no treatment with ARB showed to be independently associated with thirst, which, to our knowledge has not been described before.…”

“…8 Levels (high and low) of thirst in patients with HF on admission to hospital have been shown to be critical in predicting the trajectory of thirst after discharge to the patients home. 4 Being depressed and having fluid restriction were associated with trajectories of increased thirst, but in contrary to the other study women had trajectories of increased thirst. 4 There is no data about thirst in HF from countries with a warmer climate.…”

“…4 Being depressed and having fluid restriction were associated with trajectories of increased thirst, but in contrary to the other study women had trajectories of increased thirst. 4 There is no data about thirst in HF from countries with a warmer climate. Our previous studies present results from HF patients from a colder climate zone, the temperate zone, with cold winters and mostly mild summers.…”

“…21 Depression has been associated with increased thirst in HF patients in a previous study. 4 Stress, anxiety and depression have a significant effect on reducing saliva and causing dry mouth. 22 Depression can also enhance sensitivity to other pre-existing symptoms, and it is therefore possible that thirst is exacerbated by depression.…”

“…29 In contrary, another study showed that women experienced more thirst. 4 Studies shows that women and men can experience symptoms in different ways. For example, women can have greater symptom burden in pain, dry mouth and nausea, compared with men.…”