CLINICAL PROFILE OF HEART FAILURE PATIENTS ADMITTED IN SKIMS TERTIARY CARE HOSPITAL AND THEIR 6-12 MONTHS FOLLOWUP

Abstract

Objectives: We sought to find out the clinical profile of heart failure (HF) patients, their compliance to treatment, and their outcome. 

Background: While India has one of the largest populations of HF patients in the world, there is limited information available about HF in India, particularly in Jammu and Kashmir. An accurate account of HF in this region is critical and has the potential to influence clinical management, which may improve patient outcomes. 

Methods: The study enrolled 264 patients and they were followed for a period of one year. ESC 2016 criteria was followed for the diagnosis of HF. HF patients were classified as those with reduced ejection fraction (EF < 40%), preserved ejection fraction (EF > 50%), and those with mid-range ejection fraction (EF = 40–50%).

Results: The mean age of the patients was 57.8 (SD 15.14), males=157 ( 59.5 % ). The results reflected that the most common HF aetiology was DCM (40.2%), the most common risk factor was hypertension (59.5%)  and the most common precipitant was respiratory infection (64.4%) f/b ischemic event (20.8%). HF with preserved ejection fraction constituted 25.2% of the population. The most common in-hospital event was hypotension (26.5 %). B blocker was the most frequently used medication (61.4%). The mean hospital stay was 7.5  days (SD 5.31) with an in-hospital mortality rate of 8.7%, 28 (12.7%) patients died within 6 months and 11 (5%) of the patients died within 12 months of the index hospitalization.  Guideline-based medical treatment was given to 33.33 % of patients with LVSD. Renal failure, rehospitalization, and suboptimal medical treatment were associated with a higher risk of mortality.

Conclusion: The one-year mortality of the studied patients was around 28% which is too high to be acceptable and warrants aggressive interventions to decrease the same. The factors that showed a significant positive correlation with mortality were renal failure, hospital readmission, and suboptimal use of evidence-based treatment.