Clinical Characterstics and in Hospital Outcome of Acute Heart Failure Patients Admitted to Asella Teaching and Referral Hospital, South East Ethiopia, 2023

Background: Acute heart failure represents a significant public health concern worldwide, posing a considerable burden on healthcare systems and often leading to adverse clinical outcomes, including high mortality rates. Thus, this study aimed to describe the in-hospital outcomes and associated factors for patients with acute heart failure. Which is vital for improving the quality of care and patient management. Objective: To determine clinical characteristics and in hospital outcome of acute heart failure patient admitted at Asella teaching and referral hospital. Methodology: The study employed an institution-based retrospective cohort design and assessed the clinical characteristics and in-hospital outcomes of acute heart failure (AHF) patients admitted to Asella Teaching and Referral Hospital. Data were collected from all patients admitted between September 2022 and September 2023. After manual checks for completeness, the data were coded and entered using Epi Info version 7.2 and analyzed with SPSS version 28. Descriptive statistics were used, presenting continuous variables as mean standard deviation or median (interquartile range) based on distribution either normal or not, respectively. In addition, categorical variables were presented as frequency and percentages. Kaplan-Meier method estimated and graphed survival probabilities over time and a Log-rank hypothesis test to compare survival functions of explanatory variables was utilized. Significant predictor variables were identified by fitting a semi parametric Cox’s proportional hazard model using a method of forward stepwise and statistical significance variables were declared based on a p-value less than 0.05. Result: Two hundred thirty one (231) patients were included in the study, with 121 (52.4%) being female. The median age of patients with acute heart failure was 56 years (IQR = 28 to 70). The commonest underlying disease and precipitating factor identified at admission was ischemic heart disease (36.4%) and pneumonia (24.68%) respectively. Out of the 231 patients, 13.4% died in the hospital. In the survival analysis the hazard ratios for precipitant factor pneumonia, acute kidney injury, lack of health insurance and age were identified 3.07 (95% CI: 1.40, 6.74, p = 0.005), 2.98 (95% CI: 1.31, 6.75, p = 0.009), 3.46 (95% CI: 1.51, 7.95, p = 0.003), and 2.81 (95% CI: 1.18, 6.72, p = 0.020), respectively as predictors of poor treatment outcome. Conclusion: Unfortunately, the in-hospital mortality rate for acute heart failure proved to be high in this study. The identified independent predictors of in-hospital mortality included pneumonia, acute kidney injury, lack of active health insurance coverage and age. The principal precipitating factors leading to hospitalization were pneumonia. Ischemic heart disease was identified as the most common underlying cardiac disease. Recommendation: Improve the consistency and availability of essential investigations. work on improving drug adherence and health insurance coverage.