Clinical Characteristics, Management, and Length of Hospital Stay Between Patients with New-Onset and Acute Decompensated Chronic Heart Failure: A Prospective Cohort Study in Ethiopia

Abstract

Background: Because heart failure with de novo and acute decompensated chronic heart failure are different clinical entities, clinical characteristics, management, and length of hospital stay may also vary accordingly. Objective: To compare clinical characteristics, management, and length of hospital stay among adult heart failure patients with new-onset and acute decompensated chronic heart. Method and Participants: Prospective cohort study was conducted from 01 November 2019 to 30 April 2021 at Debre Markos Comprehensive Specialized Hospital. A total of 228 heart failure patients who fulfill inclusion criteria were included in this study. A structured data collection tool was used to collect all necessary data. Data were analyzed using Statistical Package for Social Science (SPSS) version 21.0. Bivariate and multivariate logistic regression analyses were used and P-value, <0.05 was considered statistically significant. Results: Among the 228 participants, 126 (55.3%) were females with a mean age of 53.31 ± 15.68 years. Of the study participants, 131 (57.5%) were presented with acute decompensated chronic heart failure. The median length of hospital stay was 12 days (interquartile range, 8–18). De novo heart failure patients spent less time in hospital [11 days (interquartile range, 6–16) vs 13 days (interquartile range, 9–20) in acute decompensated chronic heart failure, P = 0.004]. Mean systolic blood pressure (P = 0.006), acute decompensated chronic heart failure (P < 0.000), diabetes mellitus comorbidity (P = 0.025), and the use of angiotensin receptor blockers (P = 0.042) were independent predictors of prolonged hospital stay. During hospitalization, digoxin (61.1%) was the most frequently prescribed in de novo heart failure while diuretics (63.3%) were the most common in acute decompensated chronic heart failure at discharge. Conclusion: Heart failure patients were presented with diverse clinical characteristics. Length of hospital stay was higher in patients with acute decompensated chronic heart failure. Initiation of treatment must take into account the heterogeneity of each patient.