Magnitude of hypochloremia and associated factors among patients with acute heart failure admitted to Jimma Medical Center, Ethiopia :institution based cross sectional study

Abstract

Background: Heart failure is a global health challenge and remains a leading cause of morbidity and mortality, as well as the major reason for admission particularly in low- and middle-income countries. Patient with heart failure frequently complicates with multiple electrolyte imbalance like hypochloremia, which further more affect the survival of these patients adversely. Emerging evidences are showing the high prevalence and prognostic role of hypochloremia in heart failure. Despite its clinical significance, hypochloremia is often under-recognized and under researched, particularly in low-resource settings. Objective: To assess the magnitude of hypochloremia and its associated factors among patients with acute heart failure at Jimma Medical Centre, Ethiopia, 2025. Methods: Institution based cross sectional study design was conducted. Study population was all patient with heart failure admitted to Jimma Medical Centre during the study period and 260 study participants was selected by systematic random sampling. Data was collected from patient charts Fby using a prepared checklist. The data was analysed by Statistical Package for the Social Sciences version 26.0 and descriptive statistics were presented as percentage, means and standard deviations. The comparison of in hospital mortality rate between hypochloremic patient with heart failure and patients with acute heart failure without hypochloremia was done by chi square test. The comparison of length of hospital stays between hypochloremic patients with AHF and patients with AHF without hypochloremia was done by Mann Whitney U test. Multivariable logistic regression model was used to identify the independent factors associated with hypochloremia and P-value < 0.05 was used to declare statistical significance. Results: The prevalence of hypochloremia among patients with acute heart failure was 33.1% (95%CI: 27.4%-39.2%). The length of hospital stays was significantly higher in hypochloremic patients with acute heart failure (median: 12 days) than in the patients with acute heart failure with normal chloride level (median of 8.5 days), p=0.001. In hospital mortality rate among patients with acute heart failure with hypochloremia was significantly higher than patient with patient acute heart failure with normal chloride level (X2=8.58, p=0.003). Age, NYHA class IV, history of chronic obstructive pulmonary disease, hyponatremia, and hypokalemia were significantly associated with hypochloremia among patient with acute heart failure. Conclusion: In this study nearly one-third of patients with acute heart failure had hypochloremia. Age, NYHA class IV, history of chronic obstructive pulmonary disease, hyponatremia, and hypokalemia were identified as independent risk factors for hypochloremia.