[Early readmission and mortality in heart failure patients at a tertiary care hospital in West Africa (Ouagadougou): Predictors from a two-year retrospective study].

INTRODUCTION

Heart failure (HF) is the final common pathway of most cardiovascular diseases and remains a leading cause of hospitalization and mortality worldwide. In sub-Saharan Africa, its burden is particularly high. This study aimed to identify predictors of 30-day readmission and in-hospital mortality among patients hospitalized for HF in a tertiary care hospital in West Africa.

PATIENTS AND METHOD: It was a retrospective, descriptive, and analytical cohort study conducted at the Bogodogo University Hospital (Ouagadougou, Burkina Faso) from January 1, 2022, to December 31, 2023. All consecutive patients admitted for acute or decompensated chronic HF were included. Univariate and multivariate logistic regression analyses were performed to determine independent predictors of early readmission and mortality.

RESULTS

The hospital prevalence of heart failure (HF) was 34.28% (396/1155). At discharge, 37.63% (149/396) of patients still exhibited clinical signs of HF. The overall in-hospital mortality rate during the study period (2 years) was 17.42% (69/396). The 30-day readmission rate was 7.57% (30/396), with 69.77% of readmissions occurring within the first two weeks after discharge. The mean length of hospital stays increased from 7 days during the index hospitalization to 11 days at readmission. Independent predictors of early readmission were male sex (P=0.043), chronic kidney disease (P=0.013), hypertensive heart disease (P=0.035), and betablocker use (P=0.033). Mortality among readmitted patients was 36.66% (11/30). Independent factors associated with mortality were intercurrent infections (P=0.016), mainly pneumonia (P=0.036), the presence of a mitral regurgitation murmur (P=0.020), and ventricular arrhythmias (P=0.023).

CONCLUSION

Heart failure remains highly prevalent and severe in low-resource settings. Although the 30-day readmission rate was relatively low, early rehospitalization was strongly associated with excess mortality. Optimizing guideline-directed medical therapy and targeting modifiable predictors are essential to improve clinical outcomes.