Prevalence of anemia and its influence on treatment outcome in congestive heart failure patients attending Mulago Hospital

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dc.creator Kuule, Julius Kabbali 2013-07-02T08:26:26Z 2013-07-02T08:26:26Z 2007-06 2018-09-04T12:50:03Z 2018-09-04T12:50:03Z
dc.description A dissertation submitted to the School of Post Graduate Studies in partial fulfillment of the requirements for the degree of Master of Medicine in Internal Medicine of Makerere University
dc.description BACKGROUND: Anemia in heart failure has recently emerged as a new area of focus in as far as the adverse prognostic importance of anemia in heart failure is concerned. It has been noted that patients with congestive heart failure who have anemia have a poorer outcome, increased frequency of rehospitalisation, prolonged length of hospital stay and a higher mortality. Unfortunately most of the studies looking at anemia in congestive heart failure have been carried out in western society and there is limited literature available from sub-saharan Africa. OBJECTIVE: To determine the prevalence of anemia and its influence on treatment outcome in congestive heart failure patients attending mulago hospital. METHODS: This was a cross sectional study that employed both descriptive and analytical statistics. The study was carried out in mulago national referral hospital, which offers tertially care. 157 patients admitted through the emergency medical ward with congestive cardiac failure, were recruited consectively upon meeting the inclusion criteria. Their demographic and clinical data were recorded. All patients underwent echocardiography and had hemoglobin determined. They were then followed up till discharge or utmost for two weeks depending on which one came first and then re-assessed. RESULTS: Most patients were in NYHA class III(60%) and IV(37%). One hundred and one (64%) of the 157 patients had anemia at admission. The mean hemoglobin for the entire group was 11.2g/d1. 74% of the 53 men had anemia compared to 61% of the 104 women. Increasing age was the most important risk factor for having anemia in CHF (p=004). The most common underlying etiologies were rheumatic heart disease(RHD) seen in 45 patients, dilated cardiomyopathy (CDM) seen in 42 patients and hypertensive heart disease(HHD) seen in 40 patients. The mean fraction shortening was 24.6% but the fractional shortening for the individual etiologies was significantly different from this. The in-hospital mortality by the end of the two weeks was 10.2% with the greatest mortality significantly occurring in those with NYHA class IV(70% of the total mortality). The odds of dying were twice for the anemic patients compared to their non-anemic counterparts and this was statistically significant(p=0.05). The mean length of stay in hospital was 7.5 days but did not differ significantly between anemic and non-anemic patients. CONCLUSION: The prevalence of anemia is high among patients with congestive heart failure (CHF) attending mulago hospital and correlates with NYHA class. The presence of anemia in CHF is associated with a worse outcome.
dc.language en
dc.subject Anemia
dc.subject Congestive heart failure patients
dc.subject Mulago hospital Sub-Saharan Africa
dc.title Prevalence of anemia and its influence on treatment outcome in congestive heart failure patients attending Mulago Hospital
dc.type Thesis, masters

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