Details

Autor(en) / Beteiligte

• Kwan, Gene F
• Jean-Baptiste, Waking
• Cleophat, Philip
• Leandre, Fèrnet
• Louine, Martineau
• Luma, Maxo
• Benjamin, Emelia J
• Mukherjee, Joia S
• Bukhman, Gene
• Hirschhorn, Lisa R

Titel

Descriptive epidemiology and short-term outcomes of heart failure hospitalisation in rural Haiti

Ist Teil von

• Heart (British Cardiac Society), 2016-01, Vol.102 (2), p.140-146

Ort / Verlag

England: BMJ Publishing Group LTD

Erscheinungsjahr

2016

Link zum Volltext

Quelle

BMJ Journals Archiv - DFG Nationallizenzen

Beschreibungen/Notizen

• ObjectiveThere is increasing attention to cardiovascular diseases in low-income countries. However, little is known about heart failure (HF) in rural areas, where most of the populations in low-income countries live. We studied HF epidemiology, care delivery and outcomes in rural Haiti.MethodsAmong adults admitted with HF to a rural Haitian tertiary care hospital during a 12-month period (2013–2014), we studied the clinical characteristics and short-term outcomes including length of stay, inhospital death and outpatient follow-up rates.ResultsHF accounted for 392/1049 (37%) admissions involving 311 individuals; over half (60%) were women. Mean age was 58.8 (SD 16.2) years for men and 48.3 (SD 18.8) years for women; 76 (41%) women were <40 years of age. Median length of stay was 10 days (first and second quartiles 7, 17), and inhospital mortality was 12% (n=37). Ninety nine (36%) of the 274 who survived their primary hospitalisation followed-up at the hospital's outpatient clinic, and 18 (6.6%) were readmitted to the same hospital within 30 days postdischarge. Decreased known follow-up (p<0.01) and readmissions (p=0.03) were associated with increased distance between patient residence and hospital. Among the one-quarter (81) patients with echocardiograms, causes of HF included: non-ischaemic cardiomyopathy (64%), right HF (12%), hypertensive heart disease (7%) and rheumatic heart disease (5%). One-half of the women with cardiomyopathy by echocardiogram had peripartum cardiomyopathy.ConclusionsHF is a common cause of hospitalisation in rural Haiti. Among diagnosed patients, HF is overwhelming due to non-atherosclerotic heart disease and particularly affects young adults. Implementing effective systems to improve HF diagnosis and linkage to essential outpatient care is needed to reduce long-term morbidity and mortality.