A Joint Model for a Longitudinal Pulse Rate and Respiratory Rate of Congestive Heart Failure Patients: In Ayder Referral Hospital of Mekelle University, Tigray, Ethiopia.

Abstract

Background: Pulse rate and respiratory rates are main symptoms of congestive heart rate and the abnormal pulse rate and respiratory rate are broad indicators of major physiological instabilities. The lower pulse rate and respiratory rates are associated with a strong and healthier heart. CHF, also known simply as HF, is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. Objective: The main objective of this study is, therefore to investigate the joint evolution of pulse rate and respiratory rate of cognitive heart failure patients and identify the potential risk factors affecting the two end points in Ayder referral Hospital of Mekelle University. Methods: The latest data from 2004 E.C. up to 2005 E.C. have been taken from medical charts of 264 adult CHF patients in Ayder Referral Hospital of Mekelle University. Linear mixed effects model was fitted for the pulse rate and respiratory rate outcomes. Furthermore, a joint mixed effects model was fitted for the two end points, and the potential risk factors affecting their joint evolution are identified. Results: The baseline mean and standard deviation of both PR & RR were 126.11 &18.98bpm and 31.64 &10.99 brpm respectively. The association of the evolution for PR & RR was estimated to be ( ) which is statistically significant at 1% level of significance with 95% CI of (0.642, 0.769). Conclusions: The data analysis showed that pulse rate and respiratory rate showed a decreasing pattern over time based on the joint as well as the separate models. Furthermore, a positive and significant association was observed between the two end points and the covariates such as: sex, weight, New York Heart Association classes, age and interaction of time with weight and Left ventricle ejection fraction. While, negative and significant association was observed between two endpoints and the covariates such as: LVEF and time. Finally, to identify associated effect fitting joint model for paired endpoints is recommended.