Key result
Admission eGFR < 60mls/min/1.73m2 was an independent predictor of 180-day rehospitalization in patients with acute heart failure with reduced ejection fraction, increasing the likelihood of rehospitalization by 5.4 times.
Why the study?
Despite treatment advancements, HF rehospitalization remains high globally, but studies assessing rehospitalization rates in Nigeria are limited.
Cohort (n=148)
No
Odds Ratio: 5.4 (95% CI 1.701–7.69)
p-value: p=0.014
In acute heart failure patients in Nigeria, renal dysfunction (eGFR < 60) is a strong independent predictor of 180-day rehospitalization, identifying a high-risk group for targeted interventions.
Local HF rehospitalization data inform Nigerian pathways; leaves open generalizability and causal predictors for prospective trials.
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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Ogunmodede et al. (2022) conducted a cohort in Acute heart failure with reduced ejection fraction (HFrEF) (n=148). eGFR < 60mls/min/1.73m2 vs. eGFR ≥ 60mls/min/1.73m2 was evaluated on 180-day rehospitalization (OR 5.4, 95% CI 1.701-7.690, p=0.014). Admission eGFR < 60mls/min/1.73m2 was an independent predictor of 180-day rehospitalization in patients with acute heart failure with reduced ejection fraction, increasing the likelihood of rehospitalization by 5.4 times.
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