Incidence and predictors of 6 months mortality after an acute heart failure event in rural Uganda: The Mbarara Heart Failure Registry (MAHFER)

Fardous Charles Abeya, Boniface Amanee Elias Lumori, Suzan Joan Akello, Brian H. Annex, Andrew J. Buda, Samson Okello

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective: We sought to estimate the incidence and predictors of all-cause mortality 6 months after heart failure hospitalization in Uganda. Methods: Mbarara Heart Failure Registry is a cohort of patients hospitalized with a clinical diagnosis of heart failure at Mbarara Regional Referral Hospital, Uganda. We measured serum electrolytes, cardiac markers, and echocardiograms. All participants were followed until death or end of 6 months. We used Fine and Gray models to estimate the incidence and predictors all-cause mortality. Results: A total of 215 participants were enrolled, 141 (66%) were women, and mean age 53 (standard deviation 22) years. Nineteen (9%) had diabetes, 40 (19%) had HIV, and 119 (55%) had hypertension. The overall incidence of all-cause mortality was 3.58 (95% CI 2.92, 4.38) per 1000 person-days. Men had higher incidence of death compared to women (4.02 vs 3.37 per 1000 person-days). The incidence of all-cause mortality during hospitalization was almost twice that of in the community (27.5 vs 14.77 per 1000 person-days). In adjusted analysis, increasing age, NYHA class IV, decreasing renal function, smoking, each unit increase in serum levels of Potassium, BNP, and Creatine kinase-MB predicted increased incidence of 6 months all-cause death whereas taking beta-blockers and having an index admission on a weekend compared to a week day predicted survival. Conclusions and interpretation: There is a high incidence of all-cause mortality occurring in-hospital among patients hospitalized with heart failure in rural Uganda. Heart failure directed therapies should be instituted to curb heart failure-related mortality.

Original languageEnglish (US)
Pages (from-to)113-117
Number of pages5
JournalInternational Journal of Cardiology
Volume264
DOIs
Publication statusPublished - Aug 1 2018
Externally publishedYes

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Keywords

  • Acute heart failure
  • All-cause mortality
  • Sub-Saharan Africa

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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