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

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
StatePublished - Aug 1 2018
Externally publishedYes

Fingerprint

Uganda
Registries
Heart Failure
Mortality
Incidence
Hospitalization
MB Form Creatine Kinase
Hospital Mortality
Serum
Electrolytes
Cause of Death
Potassium
Referral and Consultation
Smoking
HIV
Hypertension
Kidney
Survival

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Incidence and predictors of 6 months mortality after an acute heart failure event in rural Uganda : The Mbarara Heart Failure Registry (MAHFER). / Abeya, Fardous Charles; Lumori, Boniface Amanee Elias; Akello, Suzan Joan; Annex, Brian H.; Buda, Andrew J.; Okello, Samson.

In: International Journal of Cardiology, Vol. 264, 01.08.2018, p. 113-117.

Research output: Contribution to journalArticle

Abeya, Fardous Charles ; Lumori, Boniface Amanee Elias ; Akello, Suzan Joan ; Annex, Brian H. ; Buda, Andrew J. ; Okello, Samson. / Incidence and predictors of 6 months mortality after an acute heart failure event in rural Uganda : The Mbarara Heart Failure Registry (MAHFER). In: International Journal of Cardiology. 2018 ; Vol. 264. pp. 113-117.
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AU - Lumori, Boniface Amanee Elias

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AU - Annex, Brian H.

AU - Buda, Andrew J.

AU - Okello, Samson

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N2 - 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.

AB - 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.

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