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埃塞俄比亚西北部贡德尔大学综合专科医院内科病房收治的急性心力衰竭患者的临床特征和住院结局。

Clinical Characteristics and In-Hospital Outcome of Acute Heart Failure Patients Admitted to the Medical Ward of University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

机构信息

Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Vasc Health Risk Manag. 2021 Sep 16;17:581-590. doi: 10.2147/VHRM.S322493. eCollection 2021.

Abstract

BACKGROUND

Despite the growing burden of heart failure in developing countries, data describing the clinical characteristics and in-hospital outcomes of acute heart failures are limited. Therefore, this study aimed at describing the clinical characteristics and in-hospital outcomes of acute heart failure patients admitted to the medical ward of University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

METHODS

A prospective observational hospital-based cross-sectional study was conducted on 226 patients with acute heart failure at the University of Gondar Comprehensive Specialized Hospital from November 2019 to October 2020. Data were collected by using a pretested data abstraction format and analyzed with Statistical Package for Social Sciences version 21. Bivariable and multivariable binary logistic regression model were fitted to identify factors associated with in-hospital outcome and reported with 95% confidence interval (CI). P-value <0.05 was considered as statistically significant.

RESULTS

The mean (± standard deviation) age of the study participant was 51.17±19.03 years and 59.3% were females. Majority, 60.6% of patients were admitted with new onset heart failure. Dyspnea (88.05%) and peripheral edema (80.5%) were the most frequent clinical findings. The in-hospital mortality was 10.6% (95% CI: 7.1-14.7). Atrial fibrillation (AOR=9.46; 95% CI: 1.49-60.29), concurrent ischemic heart disease (AOR=8.23; 95% CI: 1.15-58.89), being admitted with reduced left ventricular ejection fraction (AOR=5.36; 95% CI: 2.81-35.52), presence of orthopnea (AOR=6.63; 95% CI: 2.94-46.76), and using intranasal oxygen therapy (AOR=9.41; 95% CI: 1.35-65.82) were significantly associated with in-hospital mortality in patients with acute heart failure.

CONCLUSION

The in-hospital mortality of acute heart failure patients was relatively higher in the study area. Therefore, specific preventative and therapeutic strategies focusing on heart failure patients with reduced left ventricular ejection fraction, atrial fibrillation, ischemic heart disease, orthopnea, and intranasal oxygen therapy are required to reduce the mortality rate.

摘要

背景

尽管发展中国家心力衰竭的负担不断增加,但描述急性心力衰竭患者的临床特征和住院结局的数据有限。因此,本研究旨在描述在埃塞俄比亚西北部贡德尔大学综合专科医院内科病房住院的急性心力衰竭患者的临床特征和住院结局。

方法

2019 年 11 月至 2020 年 10 月,对贡德尔大学综合专科医院 226 例急性心力衰竭患者进行了前瞻性观察性医院横断面研究。使用预先测试的数据提取格式收集数据,并使用统计软件包 21 进行分析。采用单变量和多变量二项逻辑回归模型来确定与住院结局相关的因素,并以 95%置信区间(CI)报告。P 值<0.05 被认为具有统计学意义。

结果

研究参与者的平均(±标准差)年龄为 51.17±19.03 岁,59.3%为女性。大多数患者(60.6%)是新发心力衰竭。呼吸困难(88.05%)和外周水肿(80.5%)是最常见的临床发现。住院死亡率为 10.6%(95%CI:7.1-14.7)。心房颤动(AOR=9.46;95%CI:1.49-60.29)、合并缺血性心脏病(AOR=8.23;95%CI:1.15-58.89)、左心室射血分数降低(AOR=5.36;95%CI:2.81-35.52)、端坐呼吸(AOR=6.63;95%CI:2.94-46.76)和使用鼻内吸氧(AOR=9.41;95%CI:1.35-65.82)与急性心力衰竭患者的住院死亡率显著相关。

结论

在研究区域,急性心力衰竭患者的住院死亡率相对较高。因此,需要针对左心室射血分数降低、心房颤动、缺血性心脏病、端坐呼吸和鼻内吸氧的心力衰竭患者制定具体的预防和治疗策略,以降低死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c16/8455102/bcbb13911da3/VHRM-17-581-g0001.jpg

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