Bayesian Survival Analysis of Heart Failure Patients: A Case Study in Jimma University Medical Center, Jimma, Ethiopia

Abstract

Heart failure is failure of the heart to pump blood with normal efficiency and globally growing public health issue with high death rate over the world including Ethiopia. The aim of this study was to identify factors affecting the survival time of heart failure patients in Jimma University Medical Center. To reach the aim, 409 heart failure patients were including in the study based on data taken from medical record of patients enrolled during January, 2016 to January, 2019. Kaplan Meier plots and log rank test were used for comparison of survival function; Bayesian survival models was used to identify factors affecting the survival time heart failure patients. Of the total patients in the study 164 (40.1%) were died. The estimated median survival time of patients was 31 months. Bayesian log-normal accelerated failure time model using Markov chain monte carlo and Integrated nested laplace approximation method fit heart failure data-set better than other Bayesian accelerated failure time models used in this study. The Bayesian log-normal accelerated failure time model using Integrated nested laplace approximation method was preferable than Markov chain monte carlo method due to smaller standard error and narrow credible interval. From the results of this model shows that the survival time of heart failure patients significantly affected by age, chronic kidney disease, diabetes mellitus, etiology of heart failure, hypertension, anemia, smoking cigarette and stages of heart failure. Bayesian log-normal accelerated failure time model using Integrated nested laplace approximation method describes the heart failure data-set well. Age group (49 to 65 years and greater than 65 years); etiology of heart failure (rheumatic valvular heart disease, hypertensive heart disease and Other diseases); presence of hypertension; presence of anemic; presence of chronic kidney disease; smokers; diabetes mellitus (type I and type II diabetic); and stages of heart failure (II, III and IV) were prolong the timing death of heart failure patients. The hospital, Jimma University medical center, need to improve public awareness for early detection of heart failure.