Time to Mortality and Predictive Factors Among Adult Heart Failure Patients: Lessons From a Resource‐Limited Setting

Background: Heart failure (HF) is a major cause of morbidity and mortality in low‐resource settings like Ethiopia. This study aimed to assess time to mortality and identify key predictors among adult HF patients at Jimma Medical Center (JMC). Methods: A retrospective cohort study was conducted on 356 adult HF patients admitted to JMC between 2022 and 2023. Survival probabilities were estimated using the Kaplan–Meier method, and Cox proportional hazard regression was used to identify mortality predictors. Results: Among 356 HF patients, 15.7% (95% CI: 12.2%–19.8%) died during the study period. The median hospital stay was 11 days (IQR: 7–17), and the median age was 55 years (IQR: 38–65). Key predictors of higher mortality included hypertension (AHR: 4.6, 95% CI: 1.88–11.61, p < 0.001), pneumonia (AHR: 4.3, 95% CI: 1.15–15.78, p = 0.031), anemia (AHR: 3.3, 95% CI: 1.17–9.06, p = 0.023), acute myocardial infarction (AMI) (AHR: 4.4, 95% CI: 1.9–10.09, p < 0.001), and hyponatremia (AHR: 2.9, 95% CI: 1.44–5.99, p = 0.003). Each unit increase in systolic blood pressure (SBP) and diastolic blood pressure (DBP) was linked to a 7% and 4% lower mortality risk, respectively ( p = 0.035). A higher pulse rate was associated with a 4% increased mortality risk. Patients with heart failure with reduced ejection fraction (HFrEF) had a six‐fold higher mortality risk compared to those with preserved ejection fraction (HFpEF) (AHR: 6.1, 95% CI: 1.79–24.4, p = 0.008). Conclusion: This study identifies key mortality predictors for HF patients in a resource‐limited setting, including hypertension, pneumonia, anemia, AMI, and hyponatremia. The findings emphasize the need for targeted interventions, improved management strategies, and policies to reduce HF mortality in low‐resource environments. Further research is needed to refine these findings and enhance care for HF patients in such settings.