Yagoub Musa
Alshaab Teaching Hospital, Sudan
Title: Frequency and cause of acute decompensation and hospital re-admission in patients with chronic heart failure (ADHF- Sudan)
Biography
Biography: Yagoub Musa
Abstract
Background & Aim: Heart Failure (HF) re-admission identifies patients at high risk for adverse events. This study aimed to establish the frequency and factors associated with decompensation and readmission of patients with chronic HF at one of biggest cardiac centers in Sudan.
Method: In this prospective, observational, cross-sectional study, subjects≥18 years who re-admitted as Acute Decompensation (ADHF) at Alshaab Hospital (Khartoum-Sudan) in period from February-May 2016 were included; patients with first acute heart failure admission (Acute De-novo HF) and those who refused to participate were excluded. Descriptive statistics were used to determine the baseline characteristics of the study population and to compare them with those from other studies and registries.
Result: 220 consecutive patients are included, mean age of 63.7±14.5 years, 125 (56.8%) males. 141 (64.1%) are originally from rural areas, 151 (68.6%) are illiterates and only 4.0 (1.8%) are formally employed. 195 (88.64%) have HFrEF (EF<40%, 13 (5.91%) HFmrEF (EF 40-49%) and only 12 (5.45%) HFpEF (EF≥50%) Dilated Cardiomyopathy (DCM) was the commonest cause of heart failure in these studied patients, ischemia is the second, hypertension is the third (63.6%, 21.7%, 8.2%, respectively) while valvular heart disease is the fourth (6.5%). 51 (23.2%) re-admitted within the first 30 days, 59 (26.8%) within one to three months while half within a period of three to six months following the last discharge. During the last six months, 4.0 (1.8%) of patients re-admitted once, 38 (17.3%) twice, 66 (30%) thrice and 112 (50.9%) re-admitted ≥4 times. The cause of acute decompensation identified in 196 (89.1%) with non-adherence as the first cause of decompensation and re-admission, worsening renal function is the second, acute coronary syndrome is the third and tachyarrhythmias is the fourth (31.8% ,14.1%, 11.4% and 10.0% respectively).
Conclusion: In this study, acute decompensation and re-admission is very frequent but mostly preventable.