FACTORS ASSOCIATED WITH ADMISSION OF HEART FAILURE PATIENTS

Objective: To assess and identify various factors which are responsible for hospital admission of patients with heart failure at coronary care unit of a cardiac center in rural areas of Sindh, Pakistan. Methodology: This cross-sectional study included consecutive patients admitted to the coronary care unit (CCU) of Chandka Medical College Hospital Larkana from January to June 2016. All the patients were known cases of cardiac failure, due to any etiology, and on anti-failure treatment and their disease was stable on medications. Patients presented with new onset of heart failure were excluded. After consent demographic information, risk factors, and information regarding precipitating factors were obtained. Results: A total of 104 patients were included in this study, male to female ratio was 2:1, mean age was 57.82 (+/- 11.65) years. Hypertension was presented in 57 (54.8%) patients, 34 (32.7%) patients were diabetics, and smokers were 49 (47.1%) patients. The majority, 66 (63.5%), were presented with shortness of breath, 25 (24.0%) with orthopnea, nine (8.7%) with frank pulmonary oedema, and remaining four (3.8%) with paroxysmal nocturnal dyspnea. Precipitating factors causing rehospitalization were noncompliance of treatment 57 (54.8%), chest infections 18 (17.3%), cardiac arhythmia 11 (10.6%), myocardial ischemia seven (6.7%), and remaining 11 (10.6%) had other miscellaneous factors. One patient died during the hospital course. Conclusion: Rehospitalization of patients with heart failure in the majority of patients was due to noncompliance to treatment, other causes include respiratory tract infections and myocardial ischemia.