DETERMINE THREE MONTHS CLINICAL OUTCOMES AMONG PATIENTS PRESENTING WITH ACUTE DE-COMPENSATED HEART FAILURE
Keywords:Acute de-compensated heart failure, Re admission, Functional class, Mortality.
AbstractObjective: To determine three months clinical outcome among patients
presenting with acute de-compensated heart failure(ADHF).
Methodology: This cross sectional descriptive study was carried out at
th Cardiology Department lady Reading Hospital Peshawar, from 4 October 2011
rd to 3 July 2012. Patients with acute de-compensated heart failure (ADHF) were
included and followed for a period of three months for the outcome in the form of
mortality, worsening functional class and re-admission.
Exercise testing was performed on a treadmill according to the modified Bruce
protocol, with continuous on-line respiratory gas. The slope of the relationship
between ventilation (VE) and CO production (VCO ) was determined by 2 2
computerised graphical analysis (VE/VCO slope). 2
Results: Out of 139 patients, 52.5% were males. Age of patients ranged from 13-
90 years with mean age53.59±18.98 years. Patients were divided into four age
groups. Overall 64% patients showed adverse clinical outcome in three months
follow up. Adverse clinical outcome was 67% in male patients and 60.6% in
female patients. Total re-admission rate was 18.7% higher in less than 30 years of
patients with a rate of 35.7%. Worsening functional class was present in 30.21%
less common in patients less than 30 years age 21.4%.Mortality rate was present
in 15.1%patients as a whole and 33.3% in patients having age 71-90 years at
three months follow up.
Conclusion: Patients in acute de-compensated heart failure re admission was
much higher in younger age, while worsening of functional class and mortality
was more in older age after three months of follow up.