Association of Non-Cardiac Comorbidities with the Outcomes of Admitting Acute Heart Failure Patients in Tripoli, Libya
DOI:
https://doi.org/10.69667/lmj.2517106Keywords:
Heart Failure, Non-Cardiac Comorbidities, Outcomes, DM, Chronic Renal Disease, Tripoli, LibyaAbstract
The patients with Acute heart failure (AHF) usually present with multiple interrelated comorbidities. These comorbidities play a major role in determining the prognosis and outcome of AHF patients, as well as affecting the management. Our study aimed to describe the Effect of the presence of non-cardiac comorbidities on the outcomes of the admitting patients with AHF in Tripoli University Hospital. Method: from Jan- Oct 2022 we carried out this descriptive cross-sectional study in the cardiac de-partment and cardiac care unit in Tripoli University Hospital. A self-constructed questionnaire was designed to collect the data from medical records, and then the data was analyzed by using SPSS version 20. Results: 140 were enrolled in this study. The patients were 102 (72.9%) males and 38 (27.1%) females, their mean age was 60.08 yrs. ± SD 12.9. 128 patients (91.4%) were presented in the de-compensated stage of their previous heart failure status and 5 (3,6%) presented as cardiogenic shock. Non-compliance to treatment was the leading aggravating cause for decompensation with a percentage of 31.4% followed by infection at 29.2 %, and Atrial Fibrillation in 12.1% of the cases. Almost all enrolled patients had multiple comorbidities only 8 (5.7%) had no comorbidities. Those comorbidities include D.M in 84 patients (60%), anemia in17 patients (12.1%), chronic kidney disease (CKD) in 43 patients (30.7%) and chronic obstructive pulmonary disease (COPD) 4 (2.9%). Regarding treatment, only 10.7% of our patients were on the guidelines-directed medical therapy of heart failure (GDMT) in their discharge to home. According to the patient outcomes in this study 14 (10%) of patients needed advanced management, 12 (8.6%) died. The rest of the 114 (81.4%) responded to standard medical management mainly diuretics and GDMT. This study showed a significant statistical correlation between CKD and the worse outcomes with a (p-value = 0.055).and between cardiogenic shock and in-hospital mor-tality with a (p-value = 0.057) Conclusions: our patients were relatively young, mostly male, with a high prevalence of D.M, , more acute on chronic heart failure than denevo cases, and lower use of GDMT use, The presence of comorbidities, especially CKD as well as the presence of cardiogenic shock, are associated with increases the risk of in-hospital mortality.
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