Clinical Characteristics, Treatment Patterns and Outcomes of Hospitalized Patients with Acute Heart Failure at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia: A Cross-Sectional Study

Abstract Background: Acute heart failure (HF) is a rapid onset of new or worsening of symptoms and signs of heart failure (HF). Despite the increasing burden of HF in developing countries like Ethiopia, there is a paucity of comprehensive data with respect to clinical characteristics, treatment patterns and outcomes of acute HF. Objectives: The objective of this study is to assess the clinical characteristics, treatment patterns and outcomes of hospitalized patients with acute heart failure at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, in a year period between July 1, 2022 and July 1, 2023. Methods: This is a cross-sectional study of 303 acute HF patients who were admitted to the medical wards and intensive care unit of Yekatit 12 Hospital Medical College from July 1, 2022 to July 1, 2023. Pretested data abstraction format was used for data collection and SPSS version 26 was used for data analysis. Descriptive analysis was used to summarize sociodemographic data, clinical characteristics, treatment patterns and in-hospital outcomes of acute HF. Binary logistic regression analysis was used to determine the associated factors of in-hospital mortality. Odds ratio (OR) with the corresponding 95% confidence interval (CI) was calculated to show the strength of association. Results: Of 303 patients, 51.5% were females and the median age was 56.7 years. The most frequent symptom and sign were dyspnea (98.7%) and peripheral edema (79%), respectively. The commonest underlying cause and precipitating factor of acute HF were cor pulmonale (22.8%) and pneumonia (35.3%), respectively. The commonest anti-remodeling medications prescribed at the time of discharge were beta blockers (47.7%) followed by MRAs (42.8%) and ACE inhibitors/ARBs (38.6%) and the least prescribed were SGLT2 inhibitors (8.3%). The in-hospital mortality rate was 8.6% and the median length of hospital stay was 9 days. Based on the multivariate logistic regression analysis, the most important predictors of in-hospital mortality were systolic blood pressure (SBP) <120mmHg [(AOR) = 6.88; 95% CI: 1.84, 25.82; P value = 0.004], chloride level <96mg/dL [adjusted odds ratio (AOR) =5.23; 95% CI: 1.37, 20.07; P value = 0.016], blood urea nitrogen (BUN) >20mg/dl [AOR =5.28; 95% CI 1.36, 20.53; P value = 0.017] and presence of dyslipidemia [AOR = 4.28, 95% CI: 1.25, 14.64, P value = 0.020]. Conclusions: This study has shown that systolic blood pressure (SBP) 20mg/dL, chloride (Cl–) level <96mg/dL and presence of dyslipidemia were the most important predictor variables of in-hospital mortality for patients with acute HF. Hence, health care providers need to stratify patients with acute HF at admission based on their risk of in-hospital mortality and deal with those potential bad prognostic indicators.