TITLE:
Prognostic Factors for Acute Heart Failure (AHF) in the Cardiology Intensive Care Unit (ICU) of the University Hospital Point G (UH Pt G)
AUTHORS:
Camara Youssouf, Ba Hamidou Oumar, Sangare Ibrahima, Toure Karamba, Coulibaly Souleymane, Sacko Abdoul Karim, Coulibaly Alfousseyni, Diallo Nouhoum, Sidibe Samba, Daou Adama, Menta Ichaka, Diall Ilo Bella, Diallo Boubakar Abdoulaye
KEYWORDS:
Acute Heart Failure, Prognostic Factors, Cardiology, Intensive Care Unit, Bamako
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.9 No.1,
January
28,
2019
ABSTRACT: Background and Aim: The absence of data in our context motivates this study aiming to determine the frequency of AHF at the ICU, assess the in-hospital evolution of the disease and to find out poor prognosis.Material and Methods: It was an observational and descriptive study covering the time from January 1, 2014 to March 30, 2017 involving all inpatient records in ICU. From January 2014 to December 2017, collected data included those on socio-demographic, history of diseases and physical examination, and some labor dataincluding Pro BNP, serum creatinine, blood ionogram,cardiac enzymes and blood count. Also data electrocardiography, echocardiography and in-hospital evolution were collected. Statistical Analysis:Statistical analysis was performed using SPSS (IBM Inc) version 18. Results: AHF occured in 47.36% with a mean age of 58.74 ± 18.407 and extremes of 17 and 90 years, women representing 53.1% (sex ratio Male:Female = 0.88). Hypertension and diabetes were the predominant cardiovascular risk factors with respectively 67.4% and 18.4%. At admission44%, 37.7% and 17.9% of patients were respectively hypertensive,normotensive and hypotensive. The clinical expression was mainly global heart failure with 42.6% followed by left heart failure and right heart failure with respectively 37% and 20.4%. The coronary syndromes (all forms) was the first cause of ICA with 34% of cases followed by pulmonary embolism and hypertension with respectively 25.3% and 24.1%. Mean hospital stay was 5.61 ± 3.527 days (1 to 25 days). Complications were recorded in 18.5% of patients with cardiogenic shock in half of all cases. In multi-variate analysis, only hypotension at admission was shown to be the independent factor of poor prognosis with p = 0.016 and OR = 4.453 (1.322 - 14.996). Conclusion: As a common manifestation heart failure can be rapidly fatal in presence of collapsus or hypotension at admission. These factors should be accurately managed to reduce mortality, which remains high in our context.