Rehospitalization rate and predictors of rehospitalization in heart failure patients in North Central Nigeria

J. Ogunmodede, P. Kolo, B. Dele-Ojo, I. Yusuf, I.L. Salau, I. Katibi, A. Omotoso
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Abstract

Abstract Heart failure (HF) is a major cause of morbidity and mortality worldwide. Despite the advancement in its treatment the rate of rehospitalization of patients after treatment for HF is still high around the world. Studies assessing rehospitalization rates of HF patients are few in Nigeria. The objective of the study was to determine the 180-day rehospitalization rate and predictors of rehospitalization in acute HF patients managed in our Centre. The study was a retrospective cohort study of 148 patients with acute HF. The 180-day rehospitalization rate in our patients was 16.2%. The median time to rehospitalization was 61days. Serum urea (p=0.016), serum creatinine (p=0.033), admission eGFR < 60mls/min/1.73m2 (p=0.007), LVEF (p=0.045) were associated with rehospitalization. eGFR < 60mls/min/1.73m2 was an independent predictor of 180-day rehospitalization OR 5.4, (CI 1.701-7.690), p=0.014 suggesting 5 times greater likelihood of rehospitalization than patients with higher eGFR. The Kaplan-Meier survival curve for 180-day rehospitalization was plotted. In conclusion, the 180-day rehospitalization rate among our patients varies from other reported rates in our environment. Acute HF patients with renal dysfunction have a high likelihood of medium term rehospitalization and hence constitute an at-risk group for targeted intervention during admission.
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尼日利亚中北部心力衰竭患者再住院率及再住院预测因素
心力衰竭(HF)是世界范围内发病率和死亡率的主要原因。尽管在治疗方面取得了进步,但在世界范围内,心衰患者治疗后的再住院率仍然很高。评估心衰患者再住院率的研究在尼日利亚很少。本研究的目的是确定本中心管理的急性心衰患者180天再住院率和再住院预测因素。该研究是一项148例急性心衰患者的回顾性队列研究。180天再住院率为16.2%。再住院的中位时间为61天。血清尿素(p=0.016)、血清肌酐(p=0.033)、入院时eGFR < 60ml /min/1.73m2 (p=0.007)、LVEF (p=0.045)与再次住院相关。eGFR < 60mls/min/1.73m2是180天再住院的独立预测因子OR 5.4, (CI 1.701-7.690), p=0.014,提示再住院的可能性是eGFR较高患者的5倍。绘制180天再住院期Kaplan-Meier生存曲线。总之,我们的患者180天再住院率与我们环境中其他报告的率不同。伴有肾功能不全的急性心力衰竭患者中期再住院的可能性较大,因此是入院时进行针对性干预的高危人群。
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