Clinical Characteristics and In-Hospital Outcomes of Acute Heart Failure Patients In Ethiopia: A Retrospective Cohort Study

Background Acute heart failure (AHF) is a critical cardiovascular emergency with substantial mortality in low-resource settings. This study examines the clinical characteristics and outcomes of acute heart failure patients in Ethiopia. The burden in low-resource settings like Ethiopia remains under-characterized. Methods An institution-based retrospective cohort study was conducted at Asella Referral and Teaching Hospital, Ethiopia from September 2022 to August 2023. Patients admitted with acute heart failure during study period were included. Data were extracted from medical charts and analyzed with SPSS version 28. Descriptive statistics summarized baseline characteristics. Kaplan–Meier survival curves and long-rank tests assessed survival distributions. Cox proportional hazards models identified mortality predictors. Results Among 231 patients, 52.4% were female. The median age was 56 years (IQR 45-68). The leading precipitating factor was pneumonia (24.68%), and ischemic heart disease (36.4%) was the most common underlying condition. In-hospital mortality was 13.4%. Pneumonia (HR 3.07; 95% CI: 1.40-6.74), acute kidney injury (HR 2.98; 95% CI: 1.31-6.75), lack of health insurance (HR 3.46; 95% CI: 1.51-7.95), and age >65 years (HR 2.81; 95% CI: 1.18-6.72) were independently associated with mortality Conclusion The high in-hospital mortality among acute heart failure was significantly associated with pneumonia, acute kidney injury, lack of health insurance, and advanced age. Targeted interventions addressing these factors may improve outcomes.