Clinical Characteristics, Management, and Length of Hospital Stay Between Patients with New-Onset and Acute Decompensated Chronic Heart Failure: A Prospective Cohort Study in Ethiopia

Abstract

Background:

Because heart failure with de novo and acute decompensated chronic heart failure are different clinical entities, clinical characteristics, management, and length of hospital stay may also vary accordingly.

Objective:

To compare clinical characteristics, management, and length of hospital stay among adult heart failure patients with new-onset and acute decompensated chronic heart.

Method and Participants:

Prospective cohort study was conducted from 01 November 2019 to 30 April 2021 at Debre Markos Comprehensive Specialized Hospital. A total of 228 heart failure patients who fulfill inclusion criteria were included in this study. A structured data collection tool was used to collect all necessary data. Data were analyzed using Statistical Package for Social Science (SPSS) version 21.0. Bivariate and multivariate logistic regression analyses were used and P-value, <0.05 was considered statistically significant.

Results:

Among the 228 participants, 126 (55.3%) were females with a mean age of 53.31 ± 15.68 years. Of the study participants, 131 (57.5%) were presented with acute decompensated chronic heart failure. The median length of hospital stay was 12 days (interquartile range, 8–18). De novo heart failure patients spent less time in hospital [11 days (interquartile range, 6–16) vs 13 days (interquartile range, 9–20) in acute decompensated chronic heart failure, P = 0.004]. Mean systolic blood pressure (P = 0.006), acute decompensated chronic heart failure (P < 0.000), diabetes mellitus comorbidity (P = 0.025), and the use of angiotensin receptor blockers (P = 0.042) were independent predictors of prolonged hospital stay. During hospitalization, digoxin (61.1%) was the most frequently prescribed in de novo heart failure while diuretics (63.3%) were the most common in acute decompensated chronic heart failure at discharge.

Conclusion:

Heart failure patients were presented with diverse clinical characteristics. Length of hospital stay was higher in patients with acute decompensated chronic heart failure. Initiation of treatment must take into account the heterogeneity of each patient.

Keywords:

• heart failure
• characteristics
• management
• hospital stay

Abbreviations

ACEIs, angiotensin-converting enzyme inhibitors; ADCHF, acute decompensated chronic heart failure; ARBs, angiotensin receptor blocker; CAD, coronary artery disease; CI, confidence interval; COPD, chronic obstructive pulmonary disease; CVD, cardiovascular disorder; DMCSH, Debre Markos Comprehensive specialized Hospital; LOS, length of hospital stay; NCD, non-communicable diseases; NYHA, New York Health Association.

Data Sharing Statement

The data sets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

The Ethical Reviewer committee, College of Health Science Debre Markos University (HSC/R/C/Ser/Co/347/06/12), approved this study. This study was conducted in accordance with the Declaration of Helsinki in which it is stated that in medical research using identifiable human material or data, physicians must normally seek consent for the collection, analysis, storage and/or reuse. Before data collection, individual written consent was obtained from the study participants or caregivers. Both of them were informed about the objective of the study, procedures of selection, and assurance of confidentiality, and their names were not registered to minimize social desirability bias and enhance anonymity. Patients were not forced to participate and received any monetary incentive and it was solely voluntary based. The collected data was handled and secured with the principal investigator on every data collection day.

Acknowledgments

We thank the participants of the study and Debre Markos University.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agreed to be accountable for all aspects of the work.

Funding

This research was funded by Debre Markos University, College of Health Sciences. The University has no role in designing, conducting, and reporting the study.

Disclosure

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