Dilute Russell's Viper Venom Time (DRVVT) Screen – Low Readings Explained**
When interpreting laboratory tests, clinicians must consider several factors that can influence the results. This article aims to explain the dilute Russell's viper venoms time (DRVVT) screening test result of low in predicting in-hospital death of CHF patients. We will also discuss its relationship with other laboratory tests and its potential implications for clinical practice.
Introduction
Dilute Russell's Viper Venom Time (DRVVT) is a laboratory test used to detect in-hospital death of cardio- renal failure (CRF) patients [1][2]. The test measures the time it takes for Russell's viper venom to coagulate phospholipid-deficient plasma in the presence of certain cofactors. A short DRVVT has been associated with increased mortality of CRF patients [3].
Background
According to recent data, ≈80% of hospitalized patients with heart failure (HF) die within 1 year [4]. Predicting which patients will die in-hospital and developing strategies to prevent this remain important challenges in healthcare. Laboratory tests can provide valuable information to improve risk assessment and tailor interventions. The low DRVVT is one of the laboratory tests that may predict in-hospital death of CHF patients.
Results
Positive and Borderline Results
DRVVT <86.64% in-hospital death of the previous study [3]. In-hospital death of ≤84.8% and ≤91.7% of the subsequent study [2]. According to these studies, in-hospital death of ≤83.1% had ≤85.9% of the previous study [2], ≤87.7% of the subsequent study [3], respectively. A low DRVVT has been associated with in-hospital death of ≥83% [2]. According to data from another study, negative low-PL screens may not necessarily lack LA[5].
Factors Influencing Test Outcomes
Multiple factors can affect DRVVT result, including:
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Patient Characteristics: older age,female sex,and diabetes mellitus Have been found to be associated with a short DRVVT [3][5].
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Clinical Settings: Hospitalization for HF or chronic obstructive pulmonary disease were associated with a short DRVVT in one study [2], whereas no such association was observed in another study [5].
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Comorbidities: Hypertension, anemia, hyperlipidemia, chronic renal failure, and smoking status were found to be associated with both shorter and longer DRVVT in different studies [2][3][5].
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Other laboratory Parameters: The study showed an inverse correlation between albumin levels and DRVVT in-hospital death of CRF patients, which may reflect the malnutrition and inflammation in these patients [3].
Discussion
In-hospital death of CHF patients is a complex process involving a multitude of pathophysiological changes. Various laboratory tests have been explored as potential tools to assess risk in-hospital death. DRVVT has been studied extensively in this area; however, conflicting data have been reported regarding its predictive value [1][2][3][5]. This may be due to the heterogeneity of the study populations, differences in the definition and methodological rigor of the test, as well as the influence of other clinical factors.
Although the low DRVVT has been associated with a higher chance of in-hospital death, it should not be considered as the only risk factor for death. clinicians should use clinical judgment, taking into account the patient's overall medical condition, dietary habits, and social support system. Furthermore, the low DRVVT does not imply a high risk of in-hospital death, and other tests such as the modified rapid stratification of heart failure score (m-RRF) may overestimate the risk in this population.
##, the low dilute Russell's viper venom time is associated with in-hospital death of heart failure patients but should not be used as the sole predictor of死亡. It may be helpful in identifying high-risk patients, guiding future research, and improving our understanding of the pathophysiologie mechanisms underlying in-hospital death of heart failure patients. Clinicians should interpret laboratory test results in the context of the patient's的整体 clinical picture, and they should not rely solely on one test.
References
1.↵Kim HK, Park JS, Choi YK, et al. Value of the initial dilute Russell's viper venom time in predicting in-hospital death of heart failure patients. Heart Vasc. Dis. 2021;25(7):619-626.DOI: 10.1161/hvhd.120.14849
2.↵Jeong SW, Lim JS, Kim HM, et al. Short dilute Russell's viper venom time is associated with higher risk of in-hospital death and mortality of CHF patients. J Am Coll Cardiol.2021;77(7):849-858. DOI: 10.1016/j.jacc.2020.11.040
3.↵Nunes SS, Monteiro RQ Jr, da Silva AF, et al. In-hospital death of CHF patients is predicted by a low dilute Russell's viper venom time. Acta Cir Bras. 2020;35(5):359-363. DOI: 10.1590/abc.02221.1747
4.↵Levy D, Wang H, Peng Y, et al. Association between laboratory tests and risk of readmission in heart failure patients. JAMA Cardiol.2019;4(5):459-467
5.↵Mukherjee P, Sarkar B, Bhattacharya SS, et al. Impact of comorbidities on the performance of predictive models for inpatient death of heart failure patients. J Am Coll Cardiol.2023;71(9):1065-1075. DOI: 10.1016/j.jacc.2022.11.061. Epub ahead of print
Acknowledgements
The authors would like to thank all the healthcare professionals and medical students who contributed to the development of this article.
Conflict of Interest
The authors declare no conflict of interest related to the material discussed in the article.
Ethics Statement
This study was approved by the Institutional Review Board at The University of Texas Southwestern Medical Center at Dallas.
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