Short Term Rehospitalisation or Death and Determinants after Acute Heart Failure Admission in a Cohort of African Patients in Port Harcourt, Southern Nigeria
Okechukwu Iheji
Cardiovascular Division, Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Maclean R. Akpa *
Cardiovascular Division, Department of Internal Medicine, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Heart failure [HF] is a major health burden globally and contributes significantly to morbidity and mortality related to cardiovascular disease. The aim was to determine the outcome and factors that determine these outcomes of patients admitted for acute HF and followed up for six months.
Methodology: A hospital-based prospective study. Subjects consisted of consecutive patients with confirmed diagnosis of acute HF admitted into the medical wards of the University of Port Harcourt Teaching Hospital [UPTH] in Nigeria over 1 year. All had full physical examination and relevant investigations including echocardiography. Subjects were followed up for six months and reassessed for outcome/endpoint which were rehospitalisation or death. Factors that predicted these outcomes were also determined.
Results: There were 160 subjects, 84 females and 76 males, age range 20 to 87 years, mean 52.49±13.89 years. Sixteen (16) subjects (10.0%) were lost to follow up, 66(41.3%) showed improvement clinically, 57(35.6%) were rehospitalised while 21(13.1%) died. Determinants of rehospitalisation were New York Heart Association (NYHA) class, heart failure type, haemoglobin level at presentation and the estimated glomerular filtration rate (e GFR). Determinants of mortality were NYHA class and left ventricular ejection fraction at presentation.
Conclusion: Heart failure rehospitalisation and mortality rates of 35.6% and 13.1% respectively is high compared to developed countries.
Keywords: Heart failure, outcomes, rehospitalisation, mortality