Short-term outcomes after hospital discharge in patients admitted with heart failure in Abeokuta, Nigeria: data from the Abeokuta Heart Failure Registry

Cardiovasc J Afr. 2014 Sep-Oct;25(5):217-23. doi: 10.5830/CVJA-2014-040. Epub 2014 Sep 10.

Abstract

Background: Compared to other regions of the world, there is a paucity of data on the short-term outcome of acute heart failure (AHF) in Africa's most populous country, Nigeria. We examined the six-month outcomes (including case fatalities) in 285 of 309 AHF subjects admitted with HF to a tertiary hospital in Abeokuta, Nigeria.

Methods: The study cohort of 285 subjects comprised 150 men (52.6%) and 135 women (47.4%) with a mean age of 56.3 ± 15.6 years and the majority in NYHA class III (75%).

Results: There were a number of differences according to the subject's gender; men being older and more likely to present with hypertensive heart disease (with greater left ventricular mass) while also having greater systolic dysfunction. Mean length of stay was 10.5 ± 5.9 days. Mean follow up was 205 days, with 23 deaths and 20 lost to follow up. At 30 days, 4.2% (95% CI: 2.4-7.3%) had died and by 180 days this had increased to 7.5% (95% CI: 4.7-11.2%); with those subjects with pericardial disease demonstrating the highest initial mortality rate. Over the same period, 13.9% of the cohort was re-admitted at least once.

Conclusions: The characteristics of this AHF cohort in Nigeria were different from those reported in high-income countries. Cases were relatively younger and presented with non-ischaemic aetiological risk factors for HF, especially hypertensive heart disease. Moreover, mortality and re-admission rates were relatively lower, suggesting region-specific strategies are required to improve health outcomes.

MeSH terms

  • Acute Disease
  • Adult
  • Age Distribution
  • Aged
  • Cardiomyopathy, Dilated / complications
  • Cardiomyopathy, Dilated / epidemiology*
  • Cohort Studies
  • Female
  • Heart Failure / epidemiology
  • Heart Failure / etiology
  • Heart Failure / mortality*
  • Hospitalization
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology*
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Myocardial Ischemia / complications
  • Myocardial Ischemia / epidemiology
  • Nigeria / epidemiology
  • Outcome Assessment, Health Care
  • Patient Discharge
  • Patient Readmission / statistics & numerical data*
  • Pulmonary Heart Disease / complications
  • Pulmonary Heart Disease / epidemiology*
  • Registries*