Short-term outcomes and their predictors among patients admitted with acute heart failure in a Nigerian Teaching Hospital

Muhammad Auwal Shehu, M. Sani, B. Okeahialam
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Abstract

Background: Despite many recent advances in the evaluation and management of heart failure (HF), the development of symptomatic HF still carries a poor prognosis. A study of clinical characteristics of patients with acute heart failure (AHF) will provide appropriate clinical decisions with regard to treatment and patients' monitoring. This study therefore aimed to determine the clinical characteristics of patients admitted with AHF. The outcome measures are death, rehospitalization, or combined death/rehospitalization. Methods: It was a longitudinal study carried out on eligible AHF patients aged 18 years and above who were consecutively recruited. On presentation, all patients had history obtained and physical examination performed. Baseline blood chemistry, full blood count, electrocardiography, and echocardiography were carried out as well. Data on vital status and rehospitalization/death were recorded at 1 month, 3 months, and 6 months of follow-up periods. Results: A total of 120 patients were studied. Fifty-five percent of them were female, and the mean age was 49.88 ± 18.87 years. Of the 120 patients studied, 35 (29.2%) died, 21 (17.5%) were rehospitalized only once, and 2 (1.7%) were rehospitalized twice. Renal impairment (RI) was an independent predictor of both mortality from AHF (odds ratio [OR] = 2.875, 95% confidence interval [CI]: 1.207–6.874 and P = 0.012) and composite endpoint of death or rehospitalization (OR = 3.131, 95% CI: 1.326–7.890, and P = 0.009). Rehospitalization was significantly higher among diabetics (OR = 5.000, 95% CI: 1.604–15.586 and P = 0.006). Conclusion: AHF was associated with high mortality rate and composite endpoint of death or rehospitalization. RI and diabetes were the independent predictors of poor outcomes.
尼日利亚一家教学医院急性心力衰竭患者的短期预后及其预测因素
背景:尽管最近在心力衰竭(HF)的评估和管理方面取得了许多进展,但症状性心力衰竭的发展仍然预后不良。对急性心力衰竭(AHF)患者临床特征的研究将为治疗和患者监测提供适当的临床决策。因此,本研究旨在确定AHF住院患者的临床特征。结局指标为死亡、再住院或死亡/再住院合并。方法:采用纵向研究方法,连续招募符合条件的18岁及以上AHF患者。入院时,所有患者均有病史并行体格检查。基线血化学、全血细胞计数、心电图和超声心动图也进行了检查。在随访1个月、3个月和6个月时记录生命状况和再住院/死亡数据。结果:共研究了120例患者。其中女性占55%,平均年龄49.88±18.87岁。120例患者中,35例(29.2%)死亡,21例(17.5%)仅再住院一次,2例(1.7%)再住院两次。肾损害(RI)是AHF死亡率的独立预测因子(优势比[OR] = 2.875, 95%可信区间[CI]: 1.207-6.874, P = 0.012)和死亡或再住院的复合终点(OR = 3.131, 95% CI: 1.326-7.890, P = 0.009)。糖尿病患者的再住院率明显高于糖尿病患者(OR = 5.000, 95% CI: 1.604-15.586, P = 0.006)。结论:AHF与高死亡率及死亡或再住院的复合终点相关。RI和糖尿病是不良预后的独立预测因子。
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