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资源匮乏地区医院心力衰竭患者的死亡率及危险因素:一项多中心前瞻性观察研究

Prevalence and risk factors of mortality among heart failure patients in low resource setting hospitals: a multicenter prospective observational study.

作者信息

Bekele Firomsa, Sheleme Tadesse, Tsegaye Tesfaye, Parameswari S Angala, Syed Manjoor Ahamad, Tafese Lalise, Gezimu Wubishet

机构信息

Department of Pharmacy, Institute of Health Science, Wallaga University, Nekemte, Ethiopia.

Department of Pharmacy, College of Health Science, Mattu University, Mattu, Ethiopia.

出版信息

Front Cardiovasc Med. 2024 Nov 21;11:1429513. doi: 10.3389/fcvm.2024.1429513. eCollection 2024.

Abstract

BACKGROUND

Heart failure is a significant worldwide health problem that leads to mortality. Therefore, this study aimed to evaluate treatment outcomes and associated factors of heart failure patients who were admitted to hospitals in the southwest of Ethiopia.

METHODS AND PARTICIPANTS

A multicenter prospective observational study was conducted from 1 February to 1 August 2021. Drug therapy problems were assessed as per the Cipolle, Strands, and Morley drug therapy problems classification method. The drug therapy was registered by using the drug-related problem registration format. The results of logistic regression analysis was interpreted as crude odds ratio and adjusted odds ratio (AOR) at 95% confidence interval (CI) to determine the association between dependent and independent variables.

RESULTS

In our study settings, a total of 205 (85.1%) heart failure patients showed improvement and 36 (14.9%) died at hospital discharge. Being ≥65 years (AOR = 7.14, 95% CI: 2.04-.25.01,  = 0.002), a previous hospitalization (AOR = 6.20, 95% CI: 1.81-21.21,  = 0.004), and the presence of medication-related problems (AOR = 3.65, 95% CI: 1.13-11.73,  = 0.03) were the predictors of mortality.

CONCLUSION

The prevalence of in-hospital mortality among heart failure patients was found to be high. Previous hospitalization, older age, and the presence of drug therapy problems were the predictors of mortality among heart failure patients. Therefore, proper attention should be given to the management of elderly and re-admitted heart failure patients in addition to their regular care. In addition, hospitals should implement clinical pharmacy services to address any drug-related problems.

摘要

背景

心力衰竭是一个全球性的重大健康问题,可导致死亡。因此,本研究旨在评估埃塞俄比亚西南部医院收治的心力衰竭患者的治疗结果及相关因素。

方法与参与者

于2021年2月1日至8月1日进行了一项多中心前瞻性观察研究。根据西波勒、斯特兰兹和莫利药物治疗问题分类方法评估药物治疗问题。使用药物相关问题登记表格记录药物治疗情况。逻辑回归分析结果以95%置信区间(CI)的粗比值比和调整比值比(AOR)进行解释,以确定因变量和自变量之间的关联。

结果

在我们的研究中,共有205名(85.1%)心力衰竭患者病情好转,36名(14.9%)在出院时死亡。年龄≥65岁(AOR = 7.14,95% CI:2.04 - 25.01,P = 0.002)、既往住院史(AOR = 6.20,95% CI:1.81 - 21.21,P = 0.004)以及存在药物相关问题(AOR = 3.65,95% CI:1.13 - 11.73,P = 0.03)是死亡的预测因素。

结论

心力衰竭患者的院内死亡率较高。既往住院史、高龄以及存在药物治疗问题是心力衰竭患者死亡的预测因素。因此,除了常规护理外,还应适当关注老年和再次入院的心力衰竭患者的管理。此外,医院应开展临床药学服务以解决任何药物相关问题。

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本文引用的文献

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Management of Heart Failure in a Resource-Limited Setting: Expert Opinion from India.
Cardiol Ther. 2024 Jun;13(2):243-266. doi: 10.1007/s40119-024-00367-4. Epub 2024 Apr 30.
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Clinical Profiles and Outcomes of Heart Failure in Five African Countries: Results from INTER-CHF Study.
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