Highlights
- •The profile of acute heart failure patients from sub-Saharan Africa is that of young people with predominantly hypertensive heart failure rather than older people with ischemic heart failure.
- •Symptoms and signs of HF were assessed at entry and on days 1, 2, and 7 (or on discharge if earlier) and included oxygen saturation, degree of edema and rales, body weight, and level of orthopnea.
- •After multivariable adjustment, baseline rales and changes to day 7 or discharge in general well-being predicted death or HF hospitalization through day 60.
- •Baseline orthopnea, edema, rales, oxygen saturation, and changes to day 7 or on discharge in respiratory rate and general well-being were predictive of death through day 180.
Abstract
Background
Symptoms and signs of heart failure (HF) are the most common reasons for admission
to hospital for acute HF (AHF) and are used routinely throughout admission to assess
the severity of disease and response to therapy.
Methods and Results
The data were collected in The Sub-Saharan Africa Survey on Heart Failure (THESUS-HF)
study, a prospective, multicenter, observational survey of AHF from 9 countries in
sub-Saharan Africa. A total of 1006 patients, ≥12 years of age, hospitalized for AHF
were recruited. Symptoms and signs of HF and changes in dyspnea and well-being, relative
to admission, were assessed at entry and on days 1, 2, and 7 (or on discharge if earlier)
and included oxygen saturation, degree of edema and rales, body weight, and level
of orthopnea. The patient determined dyspnea and general well-being, whereas the physician
determined symptoms and signs of HF, as well as improvements in vital sign measurement,
throughout the admission. After multivariable adjustment, baseline rales and changes
to day 7 or discharge in general well-being predicted death or HF hospitalization
through day 60, and baseline orthopnea, edema, rales, oxygen saturation, and changes
to day 7 or on discharge in respiratory rate and general well-being were predictive
of death through day 180.
Conclusions
In AHF patients in sub-Saharan Africa, symptoms and signs of HF improve throughout
admission, and simple assessments, including edema, rales, oxygen saturation, respiratory
rate, and asking the patient about general well-being, are valuable tools in patients'
clinical assessment.
Key Words
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Article info
Publication history
Published online: September 21, 2016
Accepted:
September 13,
2016
Received in revised form:
September 2,
2016
Received:
December 4,
2015
Footnotes
Funding: THESUS-HF was funded by Momentum Research and the African Heart Initiative, Durham, North Carolina, United States of America.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
