Patterns of heart failure complications among Ambulatory cardiac patients, jimma university medical Center, Ethiopia

Abstract

Background: Chronic heart failure is a progressive condition with various causes, leading to a range of complications that contribute to early mortality and morbidity, significantly impacting patient outcomes and overall quality of life. Despite significant advances in the treatment of chronic heart failure worldwide, the patterns of complications among ambulatory cardiac patients have not yet been defined in the selected study area. Objectives: The study aimed to assess patterns of chronic heart failure complications among ambulatory cardiac patients at Jimma University Medical Center from January 1, 2022, to December 31, 2024. Methods: A hospital-based cross-sectional study was conducted among 305 medical records of adult ambulatory cardiac patient (≥ 18 years). A simple random sampling technique was employed, and data were entered into Epi-Data 3.1 and analyzed using STATA 17.0. Bivariable and multivariable logistic regression analyses were used to identify factors associated with the outcome variable. The results were presented as an adjusted odds ratio (AOR) with a 95% confidence interval. The final model considered the independent variables statistically significant at p < 0.05. Results: From the total of 305 chronic heart failure patients included in the study, the overall prevalence of chronic heart failure complications was found to be 85.9% (95% CI: 81.6 89.4). Atrial fibrillation (n=94, 30.8%), hyponatremia (n=84, 27.5%), and acute kidney injury (n=78, 25.6%) were among the most commonly identified complications. The age range of 25-54 years (AOR: 10.41, 95% CI: 2.36 - 46.04) and age ≥ 55 years (AOR: 5.32, 95% CI: 1.29 - 21.98), history of readmission (AOR: 4.29, 95% CI: 1.58-11.66), evidence of pleural effusion on the admission chest radiograph (AOR: 2.53, 95% CI: 1.13-5.66), abnormal serum sodium levels (AOR: 0.903, 95% CI: 0.85-0.96), and use of spironolactone (AOR: 0.337, 95% CI: 0.15 - 0.747) were significantly associated with chronic heart failure complications. Conclusion: The study found that eight out of ten chronic heart failure ambulatory patients were complicated, indicating a substantial burden on both patients and healthcare facilities. Hence, such patients require special attention, and adherence to patient-centered care strategies is needed to enhance the prevention and early detection of high-risk subjects