The relationship between the Haematocrit to Haemoglobin ratio and fluid balance status in medically admitted patients

Aims: The study studied the relationship between haematocrit to haemoglobin ratio (HHR) and fluid balance in Jordanian King Hussein Medical Services patients. 
Methods: Between January 2023 and May 2024, the Medical Department saw 641 adults and children. Patients with HHRs > 3.5 or below 2.5 were excluded to avoid confounding factors. The study collected haematocrit, haemoglobin, daily fluid balance, and clinical outcomes using computerised medical records. ORs and multivariate logistic regression demonstrated a strong link between HHR and fluid balance. Albumin levels were included to explain outcome differences. P-values ≤ 0.05 were significant. The study may enhance clinical volume assessment and treatment decisions by showing HHR's fluid balance effectiveness in medically hospitalised patients.
Results: 641 King Hussein Medical Centre patients had HHR and fluid balance tests.   Despite fluid imbalances, gender did not alter urine volume.   Fluid balance did not correlate with age, while those above 75 had a negative balance.   BMI was hardly significant, and 64.3% of patients had good fluid balance.   GNRI and albumin did not impact senior fluid balance.   Hospital stays under seven days altered fluid balance less.   Hgb and Hct readings did not affect fluid balance, showing that anaemia and high Hct values do not always imply fluid status.   A heart rate below three beats per minute indicated hemodilution in all patients with good fluid balance, which was closely related to haematocrit-to-hemoglobin ratio (HHR).   The study proposes evaluating patient fluid balance and medical treatment causes.   Hussein Medical Centre connected HHR, ALB, FLD_Balance_G01.   Fluid balance was unrelated to albumin, GNRI, gender, or age.   Although HHR is a strong negative indicator of positive fluid balance, its near-perfect categorisation of patients with positive fluid balance into the HHR <3 group suggests therapeutic potential.   Overweight and long-term hospitalisation may impair fluid retention, as they found minimal relationships between BMI, HLOS, and fluid balance.   Hospitalised patients should obtain HHR to differentiate haemodilution (too much fluid) from haemoconcentration. 83.9% of incidents were considered proper.   HHR inversely affects fluid balance even modestly elevated albumin.   The therapeutic efficacy of HHR for fluid status assessment in medically hospitalised patients needs more research. 
Conclusion: Hospitalised patients' fluid balance is highly predicted by the haematocrit-to-haemoglobin ratio (HHR). It beats Hgb, Hct, and albumin levels separately. Since HHR was good at discriminating, it may be therapeutic. This is different from when social and dietary factors had little influence on fluid status. Previous research has indicated that HHR aids fluid assessment. They note certain disagreements that need more research. Future prospective studies should show HHR's screening effectiveness in various patient groups and clinical settings. Thus, fact-based fluid management will include it.