Université Alassane Ouattara, Bouake, Côte d'Ivoire.
Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
BMC Cardiovasc Disord. 2023 Feb 20;23(1):94. doi: 10.1186/s12872-023-03113-1.
The Post Discharge Management of patients with heart failure impact significantly their incomes. This study aims to analyze the clinical findings and management at the first medical visit of these patients in our context.
This is a retrospective cross-sectional descriptive study on consecutive files of patients hospitalized for heart failure from January to December 2018 in our Department. We analyse data from the first post discharge medical visit including medical visit time, clinical conditions and management.
Three hundred and eight patients (mean age: 53.4 ± 17.0 years, 60% males) were hospitalized on median duration of 4 days [1-22 days]. One hundred and fifty-three patients (49,67%) were presented at the first medical visit after 66.53 days[0.06-369] on average, 10 (3.24%) patients died before this first medical visit and 145 (47.07%) had been lost to follow-up. The re-hospitalization and treatment non-compliance rates were 9.4% and 3.6%, respectively. Male gender (p = 0.048), renal failure (p = 0.010), and Vitamin K antagonist (VKA) /direct oral anticoagulant (DOAC) (p = 0.049) were the main lost to follow-up factors in univariate analysis without statistic signification in multivariate analysis. Hyponatremia (OR = 2.339; CI 95% = 0.908-6.027; p = 0.020) and atrial fibrillation (OR = 2.673; CI 95% = 1.321-5.408; p = 0.012) were the major mortality factors.
The management of patients with heart failure after discharge from hospital seems to be insufficient and inadequate. A specialized unit is required to optimize this management.
心力衰竭患者出院后的管理对其收入有重大影响。本研究旨在分析我们地区此类患者首次就诊时的临床发现和管理情况。
这是一项回顾性、横断面描述性研究，对 2018 年 1 月至 12 月期间我院因心力衰竭住院的连续病历进行了分析。我们分析了首次出院后就诊的数据，包括就诊时间、临床情况和管理。
308 例患者（平均年龄：53.4±17.0 岁，60%为男性）的中位住院时间为 4 天[1-22 天]。153 例（49.67%）患者在平均 66.53 天后[0.06-369]首次就诊，10 例（3.24%）患者在首次就诊前死亡，145 例（47.07%）失访。再入院率和治疗不依从率分别为 9.4%和 3.6%。男性（p=0.048）、肾功能衰竭（p=0.010）和维生素 K 拮抗剂（VKA）/直接口服抗凝剂（DOAC）（p=0.049）是单因素分析中主要的失访因素，但多因素分析无统计学意义。低钠血症（OR=2.339；95%CI 95%=0.908-6.027；p=0.020）和心房颤动（OR=2.673；95%CI 95%=1.321-5.408；p=0.012）是主要的死亡因素。
心力衰竭患者出院后的管理似乎不足且不充分。需要专门的单位来优化这种管理。
