Factors Associated with in-Hospital Mortality and Echocardiographic Patterns Among Patients Hospitalized with Congestive Heart Failure in Kinshasa, Democratic Republic of the Congo

Q: What are the key findings of this study?

Being 65 years of age or older independently doubled the risk of in-hospital mortality (OR 2.02), whereas systolic blood pressure ≥90 mmHg, sinus rhythm, and preserved renal function were protective.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Congestive heart failure (n=454). Intervention: Age ≥65 years vs. Age <65 years. Primary outcome: All-cause in-hospital mortality (ORa 2.02, 95% CI 1.1-3.6, p=0.015).

Q: What does this research mean for the field?

In patients hospitalized with congestive heart failure in Kinshasa, older age (65 years and older) significantly increases the risk of in-hospital mortality, whereas systolic blood pressure of at least 90 mmHg, sinus rhythm, preserved renal function, and normal serum potassium levels are protective against mortality. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Marc Tshilanda Balekelayi; Brady Makanzu Madioko; Christian Kutoloka Mabiza; Jacques Ngayuna Nkiene; Dadi-Serge Nkarnkwin Kasanza; Richard Bokele Ntshikala; Chadrack Bosenedje; Michel Tshiasuma Pipo; Yves Nsimbi Lubenga; Nathan Buila Bimbi

doi:10.2147/rrcc.s627039

October 1, 2026Research Reports in Clinical CardiologyOpen Access

Factors Associated with in-Hospital Mortality and Echocardiographic Patterns Among Patients Hospitalized with Congestive Heart Failure in Kinshasa, Democratic Republic of the Congo

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Key result

Age 65 or older linked to ~2-fold higher in-hospital mortality.

ORa 2.02
95% CI 1.1-3.6
P=0.015
n=454

Why the study?

Congestive heart failure causes significant mortality in developing countries including the Democratic Republic of the Congo, but accurate data on in-hospital mortality and echocardiographic patterns are limited.

Key Points

To identify factors associated with all-cause in-hospital mortality and echocardiographic patterns among patients hospitalized for congestive heart failure in Kinshasa.
Multicenter retrospective observational study evaluating 454 patients hospitalized with congestive heart failure across three hospitals in Kinshasa, Democratic Republic of the Congo, between June 2021 and June 2024.
Demographic, clinical, electrocardiographic, and echocardiographic variables were analyzed, and logistic regression was performed to determine independent predictors of all-cause in-hospital mortality.
All-cause in-hospital mortality was 22.5% (102 deaths), with cardiomyopathies representing the leading cause of heart failure at 52.6% (239 cases) and a mean left ventricular ejection fraction of 39.6 ± 10.5%.
Age 65 years or older independently doubled the odds of in-hospital death (adjusted OR = 2.02; 95% CI = 1.1 to 3.6; p = 0.015).
Protective factors against mortality included systolic blood pressure ≥90 mmHg (adjusted OR = 0.04; 95% CI = 0.02 to 0.08; p < 0.001), glomerular filtration rate ≥30 mL/min (adjusted OR = 0.2; 95% CI = 0.1 to 0.47; p < 0.001), sinus rhythm (adjusted OR = 0.44; 95% CI = 0.23 to 0.8; p = 0.013), and serum potassium >3.4 mmol/L (adjusted OR = 0.5; 95% CI = 0.27 to 0.9; p = 0.025).

Study Design

Type

Observational (n=454)

Multicenter

Yes

Structured PICO

P

Population

454 patients (median age 63, 61.9% female) hospitalized for congestive heart failure across three hospitals in Kinshasa, Democratic Republic of the Congo.

O

Outcome

All-cause in-hospital mortalityhard clinical

Main Result

Odds Ratio: 2.02 (95% CI 1.1–3.6)

p-value: p=0.015

Limitations

Retrospective hospital-based observational design
Diagnosis of cardiomyopathy based solely on echocardiographic, clinical, and ECG data
Significant limitations in access to other imaging modalities (cardiac MRI or coronary CT angiography) and coronary angiography
Inaccessibility of coronary angiography, preventing exclusion of cardiac ischemia and potentially overestimating the frequency of dilated cardiomyopathy

Implication

Among Congolese patients hospitalized with heart failure, in-hospital mortality is notably high (22.5%), with older age independently increasing mortality risk, whereas preserved hemodynamic and renal parameters indicate a favorable prognosis.

Abstract

Background: Congestive heart failure (CHF) has been a major health problem in developing countries in recent years and is responsible for a mortality rate that is difficult to estimate accurately due to limited data availability. The Democratic Republic of the Congo is no exception; this study provides data on this topic. Objective: To identify the factors associated with in-hospital mortality and echocardiographic patterns in patients hospitalized with congestive heart failure patients in Kinshasa city. Methodology: This is a multicenter retrospective hospital-based observational study that used non-probability convenience sampling for the selection of 454 cases of congestive heart failure hospitalized in three hospitals in the city of Kinshasa in the Democratic Republic of Congo (DRC) from June 2021 to June 2024. The data collected were analyzed with Stata/IC version 15 software. The variables were presented in the form of central tendencies and frequencies. The factors associated with mortality were identified using logistic regression; the outcome was all-cause in hospital mortality. Results: 281 women and 173 men were evaluated, with a sex ratio M/F of 0.6 with a median age of 63 years. High blood pressure (HBP) was the most common cardiovascular risk factor (68.5%). Respiratory infections were the most common contributing factor (38.7%). HF-related mortality was 22.5%. Cardiomyopathies were the most common cause of HF with 239 cases or 52.6%. The mean left ventricular ejection fraction (LVEF) of our population was 39.6 ± 10.5%. Being 65 years of age or older doubles the risk of death (ORa = 2.02; IC95% = 1.1 to 3.6; p = 0.015), while systolic blood pressure greater than or equal to 90mmHg emerged as a protective factor against HF-related mortality (ORa = 0.04; IC95% = 0.02 to 0.08; p < 0.001) with sinus rhythm (ORa = 0.44; IC95% = 0.23 to 0.8; p = 0.013), glomerular filtration rate (GFR) greater than or equal to 30mL/min (ORa = 0.2; IC95% = 0.1 to 0.47; p < 0.001) and Serum potassium level above 3.4 mmol/L (ORa = 0.5; IC95% = 0.27 to 0.9; p = 0.025). Conclusion: Cardiomyopathies are the most common cause of heart failure in our setting. Good systolic blood pressure, renal function, serum potassium levels, and sinus rhythm are associated with a favorable evolution.

Discussion

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Cite This Study

Balekelayi et al. (2026) conducted an observational in Congestive heart failure (n=454). Age ≥65 years vs. Age <65 years was evaluated on All-cause in-hospital mortality (ORa 2.02, 95% CI 1.1-3.6, p=0.015). Being 65 years of age or older independently doubled the risk of in-hospital mortality (OR 2.02), whereas systolic blood pressure ≥90 mmHg, sinus rhythm, and preserved renal function were protective.

synapsesocial.com/papers/6acc37c7d2063ff675899b5d https://doi.org/10.2147/rrcc.s627039

Topics

Heart failure

HFrEF treatment

Heart failure hospitalization

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Factors Associated with in-Hospital Mortality and Echocardiographic Patterns Among Patients Hospitalized with Congestive Heart Failure in Kinshasa, Democratic Republic of the Congo

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Topics

Factors Associated with in-Hospital Mortality and Echocardiographic Patterns Among Patients Hospitalized with Congestive Heart Failure in Kinshasa, Democratic Republic of the Congo

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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