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

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.