Diabetes in Sub-Saharan Africa: Distribution Based on Social Status in Libreville (Gabon)

[Mortality rate in patients with heart failure at the Libreville University Hospital and associated factors]

INTRODUCTION

Heart failure (HF) is a frequent cause of death in Africa. This study aims to determine the mortality rate of HF and to highlights its associated factors.

METHODS

We conducted a retrospective cross-sectional study in the Department of Cardiology at the Libreville University Hospital. It focused on the analysis of the records of patients hospitalized for left or global HF. Data were collected from January 2014 to December 2016.

RESULTS

Fatality rate accounted for 10.3%. The average age of dead patients (n=64) was 57,4 ± 17 years. Mean delay in treatment was 15± 18 days and decompensated heart failure was caused by a treatment gap in 51.4% of died patients. The association between high blood pressure and diabetes significantly increased the risk of death (OR= 2.2 (1,2-6,6)). The factors associated with mortality rate were essentially: arterial hypotension (OR=6.8 (3,2-14,1)), severe renal impairment (OR=3.5 (1,7-7,2)), cardio-thoracic index higher than 0.7 (OR= 54.4(15,3-193,1)), severe alteration in left ventricular ejection fraction (OR= 3.0(1,5-5,9)) and high NT-proBNP levels (OR=3.5(1,2-10,5)). Mortality increased significantly with the number of co-morbidities. Deaths were due to extracardiac complications in 28.4% of cases.

CONCLUSION

Heart failure mortality is related to the severity and the precocity of the lesions. Delayed treatment and co-morbidities aggravate mortality. The identification of risk factors and a therapeutic education may reduce mortality in relatively young subjects.