The Burden and Contributing Factors of Cardiogenic Pulmonary Edema Among Acute Heart Failure Patients Admitted to Tertiary Hospital, Eastern Ethiopia

Abstract

Background

Despite cardiogenic pulmonary edema is the most common phenotype of acute heart failure (AHF), studies on its burden and associated factors are limited. This study aimed to assess the burden and contributing factors of cardiogenic pulmonary edema in patients with acute heart failure admitted to a tertiary hospital in eastern Ethiopia.

Patients and Methods

An institution-based cross-sectional study was conducted on the medical records (n = 276) of patients with AHF between February 01, 2018, and January 31, 2023. A simple random sampling technique was used to select participants from the study population. Bivariable and multivariable logistic regression analyses were used to assess factors associated with the development of cardiogenic pulmonary edema. A P-value ≤0.05 was considered as statistically significant.

Results

The prevalence of cardiogenic pulmonary edema was 47.8% in AHF patients. Rural residence (adjusted odds ratio (AOR),9.54), smoking (AOR,3.17), comorbidity (AOR,2.1), and underlying cardiovascular disease (ischemic heart disease, chronic rheumatic valvular heart disease, and hypertensive heart disease with AOR: 6.71, 8.47, and 12.07, respectively) were significantly associated with the development of cardiogenic pulmonary edema in patients with AHF.

Conclusion

Nearly half of the patients with AHF had cardiogenic pulmonary edema. Being a rural dweller, cigarette smoking, comorbidities, and underlying cardiac illness were significantly associated with the development of cardiogenic pulmonary edema in patients with AHF.

Keywords:

• acute heart failure
• cardiogenic pulmonary edema
• Ethiopia
• tertiary hospital

Abbreviations

AHF, acute heart failure; AOR, Adjusted odds ratio; CI, Confidence interval; COR, Crude odds ratio; CRVHD, Chronic rheumatic valvular heart disease; ED, Emergency department; HHD, Hypertensive heart disease; IHD, Ischemic heart disease; IQR, Interquartile range; NYHA, New York Heart Association; PEF, Preserved ejection fraction; POCUS, point-of-care ultrasound; REF, Reduced ejection fraction; SBP, Systolic blood pressure.

Data Sharing Statement

The datasets of this study are available from the corresponding author on reasonable request.

Ethical Consideration

Ethical clearance was obtained from the Institutional Health Research Ethics Review Committee of Haramaya University College of Health and Medical Sciences (reference number: IHRERC/196/2022). Permission was obtained from the chief clinical director of HFCSH to conduct the study. Because this is a retrospective medical record study, patient informed permission was waived, and no personal information was included on the data collection form to maintain confidentiality. All methods were performed in compliance with the Declaration of Helsinki.

Acknowledgments

We extend our gratitude to the College of Health and Medical Sciences at Haramaya University for their support. We would also like to thank the Hiwot Fana Comprehensive Specialized Hospital administrators and medical record room staff for their cooperation during data collection. The results of this study were shared with the emergency medicine staff at the Hiwot Fana Comprehensive Specialized Hospital through a formal presentation.

Disclosure

The authors declare that they have no conflicts of interest in this work.

Additional information

Funding

There is no funding to report.