Treatment outcome and its predictors among patients of acute heart failure at a tertiary care hospital in Ethiopia: a prospective observational study

Abstract

Background: Acute heart failure is a rapid onset of new or worsening of signs and symptoms of heart failure that requires hospitalization or a visit to the emergency department. The aim of this study was to evaluate treatment outcome and determine factors that predict a poor treatment outcome in acute heart failure patients at a Tertiary Care Hospital in Ethiopia.Methods: A prospective observational study design was used. Data were collected using a structured questionnaire as a tool. Outcome variables were assessed at the time of discharge from the hospital. Bivariate and multivariate logistic regression analyses were used to determine factors that predict in-hospital mortality. A p-value ≤0.05 was considered as statistically significant.Results: Out of the 169 patients, the median age of patients with acute heart failure was 34 years (IQR = 23 to 50) and median hospital stay was 4.0 days (IQR = 3.0 to 6.0). The leading precipitating factor and underlying disease at the time of admission were pneumonia (47.5%) and chronic rheumatic heart disease (48.5%), respectively. The inhospital mortality was found to be 17.2%. Smoking (adjusted odds ratio (AOR) = 8.7, p = 0.006), diabetes mellitus (AOR = 10.2, p = 0.005), pulmonary hypertension (AOR = 4.3, p = 0.016), and the presence of adverse drug events (AOR = 4.2, p = 0.003) were predictors of in-hospital mortality.Conclusion: High in-hospital mortality was observed among acute heart failure patients admitted to a Tertiary Care Hospital in Ethiopia. Smoking, diabetes mellitus, pulmonary hypertension and the presence of adverse drug events were predictors of in-hospital mortality.

Clinical Characteristics and In-Hospital Outcome of Acute Heart Failure Patients Admitted to the Medical Ward of University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

“…In line with a previous study conducted in Ethiopia, it was revealed that pneumonia (47.5%) and drug discontinuation (22.5%) were the top precipitating factors. 21 This finding was supported by the Turkish HF registry, which reported that non-noncompliance with treatment (34%) was the most frequent factor associated with decompensation. 11 Similarly, a study conducted in Turkey explained that infection (29.3%) and non-compliance with medication (23.8%) were the frequent precipitating factors of AHF.…”

“…This finding was confirmed by other studies where ischemia, CRHD, and corpulmonale were the leading causes for AHF related hospital admission. 13,14,17,21 Despite the majority, 31.4% of patients were admitted with an unknown precipitating factor, CAP (48.2%) was the main precipitant factors among new-onset AHF patients, while non-compliance to the medication (42.6%) was the leading one among ADCHF patients. In line with a previous study conducted in Ethiopia, it was revealed that pneumonia (47.5%) and drug discontinuation (22.5%) were the top precipitating factors.…”

“…This finding was confirmed by other studies where ischemia, CRHD, and corpulmonale were the leading causes for AHF related hospital admission. 13 , 14 , 17 , 21 …”

“…Data abstraction format was prepared by reviewing similar studies. 4 , 11 , 13 , 14 , 17 , 18 , 21 , 22 Data regarding demographic variables, medical history, medication use, clinical presentation on admission, echocardiographic and laboratory findings, in-hospital treatment and outcomes were collected and recorded on the data abstraction format from admission until their discharge from the ward. Information on the clinical characteristics, management and in-hospital outcome of AHF patients were collected through medical chart review.…”

Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia

“…Adopting these “self-care” behaviors can be overwhelming to patients, and adherence is often poor [ 16 ]. In Ethiopia, several studies have found poor self-care management practices among CHF patients [ 17 – 19 ] and the country has high CHF-related hospital admissions and deaths [ 20 , 21 ], with poor medication adherence being the major risk factor [ 21 ]. Unlike other common chronic diseases such as diabetes and HIV, there are no policies for systematically providing self-care instructions to CHF patients’ in Ethiopia [ 22 ].…”