000			02998nam a22003257a 4500
003			OSt
005			20240305193746.0
008			221206b |||||||| |||| 00| 0 eng d
028			_bPhone: +255 28 298 3384
028			_b Fax: +255 28 298 3386
028			_b Email: vc@bugando.ac.tz
028			_b Website: www.bugando.ac.tz
040			_bEnglish _cDLC
041			_aEnglish
100			_aJustin R Kingery _946668
222			_aGlobal health Global disease patterns Heart failure mortality
245			_aHeart failure, post-hospital mortality and renal function in Tanzania: A prospective cohort study
260			_aMwanza, Tanzania: _b Elsevier & _b Catholic University of Health and Allied Sciences [CUHAS – Bugando] _c2017/9/15
300			_a Pages 311-317
490			_v International journal of cardiology Volume 243
520			_aAbstract: Objective: To determine one-year, post-hospital mortality and the predictors of mortality in Tanzanian adults with heart failure (HF) compared to other admitted adults. Methods: In this prospective cohort study we consecutively enrolled medical inpatients admitted during a 3-month period, screened for HF and followed until 12 months after hospital discharge. Standardized history, physical examination, echocardiography and laboratory investigations were obtained during hospital presentation. The primary outcome was one-year post-discharge mortality. The secondary outcome was in-hospital mortality. Cox regression adjusted for age and sex was used. Results: During the study period, we enrolled 558 adults; 145 had HF and 107 of these survived until discharge. Patients with HF had a higher one-year post-hospital discharge mortality than all other diagnoses (62/107 (57.9%) vs 150/343 (43.7%), respectively, HR = 1.57[1.13–2.18]). In-hospital mortality was similar. Markers of renal disease were more common in adults with HF (40/107 (37.4%) and were the strongest independent predictors of post-hospital mortality: low eGFR (HR = 2.94[1.62–5.31]) and proteinuria (HR = 2.03, [95%CI 1.13–3.66]). No patients discharged with the combination of low eGFR/proteinuria survived to the one-year endpoint. Of note, 79/145 (54.5%) of adults admitted with HF were newly diagnosed during hospital admission. Conclusions: Over half of adults discharged with HF died within 12 months after discharge. Adults with HF had higher post-hospital mortality compared to other medical inpatients. Markers of renal disease were the strongest predictor of this mortality. Innovative interventions are needed to reduce post-hospital mortality in adults with HF and should focus on those with renal disease.
700			_a Missana Yango _923031
700			_aBahati Wajanga _923033
700			_a Fredrick Kalokola _922761
700			_a Josef Brejt _946744
700			_a Johannes Kataraihya _923586
700			_a Robert Peck _922817
856			_uhttps://doi.org/10.1016/j.ijcard.2017.05.025
942			_2ddc _cVM
999			_c19935 _d19935