Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
March 2021, Vol. 10(1), pp. 001-010
Copyright © 2021 Global Advanced Research Journals
Full Length Research Paper
Outcome of acute heart failure hospitalizations and its associates in a teaching hospital in Makurdi, North Central Nigeria
Ihunanya Chinyere Okpara1*, Tsavyange Peter Mbaave1, Doofan Ortese Ayatse2, Terhile Igbah2
1Department of Medicine, P.M.B. 102119, Benue State University Makurdi, Nigeria.
2Department of Internal Medicine, P.M.B. 102131, Benue State University Teaching Hospital Makurdi, Nigeria.
*Corresponding Author E-mail: firstname.lastname@example.org; Phone: 08037067040
Accepted 01 April, 2021
Heart failure is the end stage of most heart diseases affecting millions of people worldwide with high mortality rate and enormous financial burden. This economic burden is largely attributed to high rates of short term and frequent hospitalization. The aim of our study is to determine the associates of inhospital mortality and short term rehospitalisation in our centre. This was a hospital based retrospective cohort study. The case records of patients admitted for acute heart failure at the medical wards of Benue State University teaching Hospital Makurdi were used to obtain demographic, clinical, laboratory and electrocardiographic records. Echocardiographic records were obtained from case notes and echo records. Inhospital mortality and rehospitalisation records were obtained from case notes. Pearson chi-square was used to determine the associates of the outcome. There were 76 subjects with 44(57.9%) males and 32(42.1%) females. The mean age of the population was 52.37±13.46 years. The inhospital mortality rate was 7.9% while the short term rehospitalisation rate was 17.1%. There were significant associations between inhospital mortality and heart failure with preserved ejection fraction (χ2 = 6.877; p = 0.009) and anaemia (χ2 = 7.717; p = 0.005). There was significant association between age and short term rehospitalisation (χ2 = 4.141; p = 0.042). The inhospital mortality rate obtained in our study is comparable to other African studies. Close attention should be paid to patients with heart failure with preserved ejection fraction, anaemia, elderly patients and treatment of comorbidities in the management of heart failure.
Keywords: Heart failure with preserved ejection fraction, anaemia, inhospital mortality, rehospitalisation.
Abraham WT, Fonarow GC, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, et al (2008). Predictors of in-hospital mortality in patients hospitalized for heart failure: insights from the Organized Program to initiate Lifesaving Treatments in Hospitalized Patients with heart Failure (OPTIMIZE-HF). J. Am. Coll. Cardiol. 52(5): 347 356.
Akpa MR, Iheji O (2018). Short-term rehospitalisation or death and determinants after admission for acute heart failure in a cohort of African patients in Port Harcourt, southern Nigeria.Cardiovasc. J. Afr. 29(1): 46 – 50.
American Heart Association Committee Report (1975). Recommendations for standardization of leads and specifications for instruments in electrocardiography and vectocardiography. Circulation. 51: 11 – 13.
Amoah AGB, Kallen C (2000). Aetiology of heart failure as seen from a National Cardiac Referral Centre in Africa. Cardiol. 93: 11 – 18.
Ather S, Lyass A, Kraigher-Krainer E, Massaro JM, Lee DS, Ho JE, et al (2012). Cardiac dysfunction and noncardiac dysfunction as precursors of heart failure with reduced and preserved ejection fraction in the community. Circulation. 59(11): 998 – 1005.
Bhuiyan T, Maurer MS (2011). Heart failure with preserved ejection fraction: Persistent diagnosis, therapeutic enigma. Curr. Cardiovasc. Risk Rep. 5: 440 – 449.
Chan MM, Lam CS (2013). How do patients with heart failure with preserved ejection fraction die? Eur. J. Heart Fail. 15 (6): 604 – 613.
Chen J, Normand SL, Wang Y, Krumholz HM (2011). National and regional trends in heart failure hospitalization and mortality rates for Medicare beneficiaries, 1998 – 2008. JAMA. 306 : 1669 – 1678.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al (2003). Seventh report of the Joint National Committee on Prevention, detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 42: 1206 – 1252.
Cluzol L, Cautela J, Michelet P, Roch A, Kerbaul F, Mancini J, et al (2017). Prehospital and in-hospital course of care for patients with acute heart failure: Features and impact on prognosis in ‘real life’. Arch. Cardiovasc. Dis. 110 (2): 72 – 81.
Damasceno A, Majosi BM, Sani M, Ogah OS, Mondo C, Ojji D, et al (2012). The causes, treatment, outcome of acute heart failure in 1006 Africans from 9 countries. Arch. Intern. Med. 172: 1386 – 1394.
Davis RC, Hobbs FDR, Lip GYH (2000). ABC of heart failure. History and epidemiology. Br. Med. J. 320: 39 – 42.
Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, et al (1986). Echocardiographic assessment of left ventricular hypertrophy: Comparison to necropsy findings. Am. J. Cardiol. 57: 450 – 458.
Devereux RB, Lutas EM, Casale PN, Kligfield P, Eisenberg RR, Hammond IW, et al (1984). Standardization of M-mode echocardiographic left ventricular anatomic measurements. J. Am. Coll. Cardiol. 4(6): 1222 – 1230.
Du Bois D, Du Bois E (1916). A formula to estimate the appropriate surface area, if height and weight be known. Arch. Intern. Med. 17: 863 – 867.
Edelmann F, Stahrenberg R, Gelbrich G, Durstewitz K, Angermann CE, Dungen HD, et al (2011). Contribution of co-morbidities to functional impairment is higher in heart failure with preserved than with reduced ejection fraction. Clin. Res. Cardiol. 100(9): 755 – 764.
Falase AO, Ayeni O, Sekoni GA, Odia OJ (1983). Heart failure in Nigerian hypertensives. Afr. J. Med. Sci. 12(1): 7 – 15.
Familoni OB, Olunuga TO, Olufemi BW (2007). A clinical study of pattern and factors affecting outcome in Nigerian patients with advanced heart failure. Cardiovasc. J. Afr. 18: 308 – 311.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry D, Borden WB, et al (2013). Heart diseases and stroke statistics-2013 update: a report from the American Heart Association. Circulation. 127(1): e6-e245.
Hallan S, Assberg M, Johnsen H (2004). Validation of the Modification of Diet in Renal Disease formula for estimating GFR with special emphasis on calibration of the serum creatinine assay. Am. J. Kidney Dis. 44: 84 – 93.
Ho KK, Pinsky JL, Kannel WB. Levy D (1993). The epidemiology of heart failure: the Framingham Study. J. Am. Coll. Cardiol. Oct 22 (4 suppl A): 6A – 13A.
Kang DH, Park ST, Shin SH, Hong GR, Lee S, Kim MS, et al (2019). Angiotensin receptor nepilysin inhibitor for functional mitral regurgitation. Circulation. 139(11): 1354 – 1365.
Karaye KM, Sani MU (2008). Factors associated with poor prognosis among patients admitted with heart failure in a Nigerian tertiary medical centre: a cross-sectional study. Br. Med. Coll. Cardiocasc. Disord. 8: 16 – 16.
Kengne AP, Dzudie A, Sobngwi E (2008). Heart failure in sub-Saharan Africa: A literature review with emphasis on individuals with diabetes. Vasc. Health Risk Manag. 4(1): 123 – 130.
Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al (2005). Recommendations for chamber quantification: A report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J. AM. Soc. Echocardiogr. 18: 1440 – 1463.
Lee DS, Gona P, Vasan RS, Larson MG, Benjamin EJ, Wang TJ, et al (2009). Relation of Disease Pathogenesis and Risk Factors to Heart Failure With Preserved or Reduced Ejection Fraction: Insights From the Framingham Heart Study of the National Heart, Lung, and Blood Institute. Circulation. 119(24): 3070 – 3077.
Logeart D, Isnard R, Resche-Rigon M, Seronde MF, de Groote P, Jondeau G, et al (2013). Current aspect of the spectrum of acute heart failure syndromes in a real-life setting: the OFICA study. Eur. J. Heart Fail.15: 465 – 476.
Loh JC, Creaser J, Rourke DA, Livingstone N, Harrison TK, Vandenbogaart E, et al (2013). Temporal trends in treatment and outcomes for advanced heart failure with reduced ejection fraction from 1993 – 2010: findings from a university referral center. Circ. Heart Fail. 6(3): 411 – 419.
Maggioni AP, Dahlstrӧm U, Filippatos G, Chioncel O, Leiro MC, Drozdz J, et al (2013). EURObservational Research programme: regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot). Eur. J. Heart Fail.15: 808 – 817.
McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bӧhm M, Dickstein K, et al (2012). ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur. J. Heart Fail.14: 803 – 869.
Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Follath F, Harjola V, et al (2006). EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population. Eur. Heart J. 27 (22): 2725 – 2736.
Nohria A, Lewis E, Stevenson LW (2002). Medical management of advanced heart failure. J. Am. Med. Assoc. 287: 628 – 640.
Ogah OS, Adebiyi A, Silwa K (2019). Heart failure in sub-Saharan Africa, Topics in Heart failure Management.,Giuseppe Rescigno and Micheal S. Firstenberg, IntechOpen. DOI: 10.5772/intechopen.82416. Available from: https://www.intchopen.com/book/topics-in-heart-failure-management/heart failure-in-sub-saharan-africa
Ogah OS, Stewart S, Falase AO, Akinyemi JO, Adegbite GD, Alabi AA, et al (2014). Contemporary profile of acute heart failure in Southern Nigeria: Data from the Abeokuta heart failure clinical registry. JACC heart Failure. 2(3): 250 – 259.
Ogah OS, Stewart S, Falase AO, Akinyemi JO, Adeghite GD, Alabi AA, et al (2014). Predictors of rehospitalisation in patients admitted with heart failure in Abeokuta, Nigeria: Data from the Abeokuta heart failure registry. J. Card. Fail. 20: 833 – 840.
Ojji DB, Alfa J, Ajayi SO, Mamven MH, Falase AO (2009). Pattern of heart failure in Abuja, Nigeria: an echocardiographic study. Cardiovasc. J. Afr. 20(6): 349 – 352.
Okello S, Rogers O, Byamugisha A, Rwebembera J, Buda AJ (2014). Characteristics of acute heart failure hospitalizations in a general medical ward in Southwestern Uganda. Int. J. Cardiol. 176(3): 1233 – 1234.
Oyoo GO, Ogola EN (1999). Clinical and socio demographic aspects of congestive heart failure patients at Kenyatta National Hospital, Nairobi. East Afr. Med. J. 76: 23 – 27.
Permanyer Miralda G, Soriano N, Brotons C, Moral I, Pinar J, Cascant P, et al (2002). Baseline characteristics and determinants of outcome in a patient population admitted for heart failure to a general hospital. Rev. Esp. Cardiol. 55(6): 571 – 578.
Roger VL, Weston SA, Redfield MM, Hellermann-Homan JP, Killian J, Yawn BP, et al (2004). Trends in heart failure incidence and survival in a community-based population. JAMA. 292: 244 – 350.
Shah SJ, Gheorghiade M (2008). Heart failure with preserved ejection fraction: Treat now by treating comorbidities. JAMA. 300: 431 – 433.
Shah SJ, Heitner JF, Sweitzer NK, Anand IS, Kim HY, Harty B, e al (2012). Baseline characteristics of patients in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) Trial. Circ. Heart Fail. 6(2): 184 – 192.
Silwa K, Davison BA, Mayosi BM, Damasceno A. Sani M, Ogar OS, et al (2013). Readmission and death after acute heart failure event: predictors and outcomes in sub-Saharan Africa: results from the THESUS-HF registry. Eur. Heart J. 34(40): 3151 – 3159.
Steinberg BA, Zhao X, Heidenreich PA, Peterson ED, Bhatt DL, Cannon CP, et al (2012). Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: Prevalence, therapies, and outcomes. Circulation.126: 65 – 75.
Stewart S, MacIntyre K, Hole DJ, Capewell S, McMurray JJ (2001). More ‘malignant’ than cancer? Five-year survival following a first admission for heart failure. Eur. J. Heart Fail. 3: 315 – 322.
Stewart S, Wilkinson D, Hansen C, Vaghela V, Mvungi R, McMurray J, et al (2008). Predominance of heart failure in the heart of Soweto study cohort: emerging challenges for urban African communities. Circulation.118: 2360 – 2367.
Tantchou Tchoumi JC, Ambassa JC, Kingue S, Giamberti A, Cirri S, Frigiola A, et al (2011). Occurence, aetiology and challenges in the management of congestive heart failure in sub-Saharan Africa: experience of the Cardiac Centre in Shisong, Cameroon. Pan-Afr. Med. J. 8: 11 – 11.
Teicholz LE, Kreulen T, Herman MV, Gorlin R (1976). Problems in echocardiographic volume determinations: echocardiographic-angiographic correlations in the presence of absence of asynergy. Am. J. Cardiol. 37(1): 7 – 11.
Weintraub NL, Collins SP, Pang PS, Levy PD, Anderson AS, Arslanian-Engoren C (2010). Acute heart failure syndromes: emergency department presentation, treatment, and disposition: current approaches and future aims: a scientific statement from the American Heart Association. Circulation.122: 1975 – 1996.
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