Ogah Okechukwu S, Stewart Simon, Falase Ayodele O, Akinyemi Joshua O, Adegbite Gali D, Alabi Albert A, Durodola Amina, Ajani Akinlolu A, Sliwa Karen
Division of Cardiology, Department of Medicine, University College Hospital, Ibadan, Nigeria; Soweto Cardiovascular Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
NHMRC Centre of Research Excellence to Reduce, Inequality in Heart Disease Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
Cardiovasc J Afr. 2014 Sep-Oct;25(5):217-23. doi: 10.5830/CVJA-2014-040. Epub 2014 Sep 10.
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.
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%).
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.
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.
与世界其他地区相比,在非洲人口最多的国家尼日利亚,关于急性心力衰竭(AHF)短期预后的数据匮乏。我们研究了尼日利亚阿贝奥库塔一家三级医院收治的309例因心力衰竭入院的AHF患者中285例的六个月预后情况(包括病例死亡率)。
285例研究队列受试者中,男性150例(52.6%),女性135例(47.4%),平均年龄56.3±15.6岁,大多数处于纽约心脏协会(NYHA)心功能Ⅲ级(75%)。
根据受试者性别存在一些差异;男性年龄更大,更易出现高血压性心脏病(左心室质量更大),同时收缩功能障碍也更严重。平均住院时间为10.5±5.9天。平均随访时间为205天,23例死亡,20例失访。30天时,4.2%(95%可信区间:2.4 - 7.3%)死亡,到180天时,这一比例增至7.5%(95%可信区间:4.7 - 11.2%);患有心包疾病的受试者初始死亡率最高。在同一时期,该队列中有13.9%的患者至少再次入院一次。
尼日利亚这一AHF队列的特征与高收入国家报告的不同。病例相对年轻,呈现出心力衰竭的非缺血性病因风险因素,尤其是高血压性心脏病。此外,死亡率和再次入院率相对较低,这表明需要采取针对该地区的策略来改善健康结局。