Management, clinical Outcomes, and Its Predictors among Heart Failure Patients Admitted to Tertiary Care Hospitals in Ethiopia: Prospective Observational Study

Abstract

Abstract Background Heart failure is a global pandemic, as it affects approximately 64.34 million people worldwide with a $346.17 billion global economic burden. The prevalence of heart failure has increased from 43.4–46.5% in the last 10 years in lower and middle-income countries. This study aimed to assess management, clinical outcomes and their predictors among heart failure patients admitted to tertiary care hospitals in Ethiopia. Methods A prospective observational study design was conducted on heart failure patients admitted at two tertiary care hospitals in Ethiopia from September 2020 to May 2021. The primary outcome of the study was 90-day all-cause mortality. Data were analyzed using SPSS version 23.0. A multivariate Cox regression model was performed to identify independent predictors of 90-day all-cause mortality. Variables with P-values < 0.05 were considered statistically significant. Results Out of 283 patients enrolled in this study, 52.3% were male and the mean (± SD) age was 52.4 ± 17.9 years. The most common medications prescribed during hospitalization and discharge were diuretics (98.9% vs 95.6%), ACEIs/ARBs (48.8% vs 67.3%), and beta-blockers (46.6% vs 64.7%), respectively. In the present study, the 90-day all-cause mortality was 10.2%. Hypertension (HR = 3.70, 95%CI = 1.18–11.61), cardiogenic shock (HR = 8.66, 95%CI = 3.15–20.82), and reduced ejection fraction (HR = 1.47, 95%CI = 1.06–3.79) were predictors of 90-day all-cause mortality. Conclusion High 90-day all-cause mortality was observed among heart failure patients in the present study. Alcohol drinking, hypertension, cardiogenic shock, and reduced ejection fraction were predictors of poor treatment outcomes for whom closer follow-up or further interventions may be considered.