Hemoconcentration has been proposed as a surrogate for successful decongestion in acute heart failure. We studied the relationship between hemoconcentration and clinical measures of decongestion.

There was a poor correlation between the magnitude of hematocrit changes and the degree of improvement in congestion score as assessed by clinical examination.

Persistent clinical congestion at hospital discharge was present in a significant proportion of patients despite hemoconcentration (23.9%) and was associated with increased risk for mortality and heart failure rehospitalizations.

Furthermore, hemoconcentration was absent in many patients (71.0%) without clinical evidence of congestion at hospital discharge.