Bivigou Elsa Ayo, Allognon Mahutondji Christian, Ndoume Francis, Mipinda Jean Bruno, Nzengue Emmanuel Ecke
Département de Cardiologie, Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon.
Service de Cardiologie, Centre Hospitalier Universitaire de Libreville, Libreville, Gabon.
Pan Afr Med J. 2018 Sep 13;31:27. doi: 10.11604/pamj.2018.31.27.13259. eCollection 2018.
Heart failure (HF) is a frequent cause of death in Africa. This study aims to determine the mortality rate of HF and to highlights its associated factors.
We conducted a retrospective cross-sectional study in the Department of Cardiology at the Libreville University Hospital. It focused on the analysis of the records of patients hospitalized for left or global HF. Data were collected from January 2014 to December 2016.
Fatality rate accounted for 10.3%. The average age of dead patients (n=64) was 57,4 ± 17 years. Mean delay in treatment was 15± 18 days and decompensated heart failure was caused by a treatment gap in 51.4% of died patients. The association between high blood pressure and diabetes significantly increased the risk of death (OR= 2.2 (1,2-6,6)). The factors associated with mortality rate were essentially: arterial hypotension (OR=6.8 (3,2-14,1)), severe renal impairment (OR=3.5 (1,7-7,2)), cardio-thoracic index higher than 0.7 (OR= 54.4(15,3-193,1)), severe alteration in left ventricular ejection fraction (OR= 3.0(1,5-5,9)) and high NT-proBNP levels (OR=3.5(1,2-10,5)). Mortality increased significantly with the number of co-morbidities. Deaths were due to extracardiac complications in 28.4% of cases.
Heart failure mortality is related to the severity and the precocity of the lesions. Delayed treatment and co-morbidities aggravate mortality. The identification of risk factors and a therapeutic education may reduce mortality in relatively young subjects.
心力衰竭（HF）是非洲常见的死亡原因。本研究旨在确定HF的死亡率并突出其相关因素。
我们在利伯维尔大学医院心脏病科进行了一项回顾性横断面研究。重点分析因左心或全心衰住院患者的记录。数据收集时间为2014年1月至2016年12月。
病死率为10.3%。死亡患者（n = 64）的平均年龄为57.4±17岁。平均治疗延迟时间为15±18天，51.4%的死亡患者因治疗间隔导致失代偿性心力衰竭。高血压和糖尿病之间的关联显著增加了死亡风险（OR = 2.2（1.2 - 6.6））。与死亡率相关的因素主要有：动脉低血压（OR = 6.8（3.2 - 14.1））、严重肾功能损害（OR = 3.5（1.7 - 7.2））、心胸指数高于0.7（OR = 54.4（15.3 - 193.1））、左心室射血分数严重改变（OR = 3.0（1.5 - 5.9））和高NT - proBNP水平（OR = 3.5（1.2 - 10.5））。死亡率随合并症数量显著增加。28.4%的病例死亡原因是心外并发症。
心力衰竭死亡率与病变的严重程度和早期发生有关。治疗延迟和合并症会加重死亡率。识别危险因素和进行治疗教育可能降低相对年轻患者的死亡率。
