Acute heart failure outcome and predictors of outcome among patients admitted to Jimma University Medical Center, Southwest Ethiopia

Abstract

Background: Acute heart failure (AHF) is a life-threatening medical condition requiring urgent evaluation and treatment. Despite the high burden of the disease in Ethiopia, limited studies and literatures are available that describe the clinical characteristics, and outcome of the disease in the country. Objectives: To determine the etiology, precipitating factors and treatment outcome and predictors of outcome among patients with AHF admitted to Emergency and Medical ward, Jimma university medical center, Southwest Ethiopia from July 12, 2021 to January 10, 2022.Methods: A prospective cohort study was conducted in AHF patients admitted to Emergency and Medical ward. We used Purposive sampling technique to get the sample population. Data were collected using a structured questionnaire developed according to the guidelines of Ethiopian national major non-communicable diseases assessment, European Society of Cardiology, and ACC/AHA. Imaging findings (chest X-ray, electrocardiogram, and echocardiography), treatments given and hospital stay were abstracted from the patient’s card. SPSS software version 26 was used for data analysis. The level of significance was chosen at 5% and p–value ≤ 0.05 was reported statistically significant and results were reported as 95% confidence intervals.Result: We enrolled 184 AHF patients. Ninety eight (53.3%) patients were males. The mean age of the participants was 48.33(±18.855). Out of the total patients, 90 (48.9%) had denovo heart failure, 94 (51.1%) had acute decompensated heart failure (ADHF) and 66 (70.2%) of those with ADHF had readmission history of more than two times in the past 1 year.The most common chest X-ray findings in the patients were cardiomegaly; 168(91.3%). The most common identified precipitating cause for AHF was pneumonia; 54(29.3%). Systemic hypertension was the most common comorbidity being seen in 52 (28.3%) patients. Yet, pulmonary hypertension, chronic kidney disease, chronic obstructive pulmonary disease and tuberculosis were the next common comorbidities being found in 46 (25%), 31(16.8%), 12 (6.5%), 9 (4.9 %) respectively.Smoking history, admission systolic blood pressure, presence of acute coronary syndrome as precipitating factor, presence of chronic kidney disease as a comorbidity, blood urea nitrogen (BUN), and troponin were all predictors in hospital mortality. Conclusion: Pneumonia and hypertension were the most common identified precipitating factors and comorbidities, respectively. Acute coronary syndrome, chronic kidney disease, smoking, and BUN are independent predictors of mortality in hospitalized AHF patients in JUMC.