Low DE was associated with worsened survival even after adjusting for in-hospital diuretic dose , fluid output , in addition to baseline characteristics ( Penn : hazards ratio [ HR ] , 1.36 ; 95 % confidence interval [ CI ] , 1.04-1 .78 ; P = 0.02 ; ESCAPE : HR , 2.86 ; 95 % CI , 1.53-5 .36 ; P = 0.001 ) .