Abstract 12789: Clinical Factors Associated With Mortality Among Patients Hospitalized for Heart Failure in Egypt

Abstract

Introduction: Heart failure (HF) is a growing public health burden in many low and middle-income countries (LMIC). However, most HF registries were conducted in high income countries, which often have different ethnic and cultural backgrounds from that of LMIC. Hypothesis: Independent clinical variables associated with mortality in patients hospitalized for HF in Egypt are different from those established in the United States (US). Methods: Between 2011 and 2014, 1,660 patients hospitalized for HF were enrolled from 20 centers across Egypt as part of the European Society of Cardiology HF long-term Registry. Deceased patients were compared to survivors, to identify demographic, clinical and biochemical variables associated with in-hospital and one-year mortality. Variables associated with mortality on univariate analysis, and independent variables identified in the Acute Decompensated Heart Failure National Registry (ADHERE) and in the Seattle Heart Failure Model, both based in the US, were entered into the multivariate logistic regression model. Results: In-hospital mortality was 5%. Only two independent clinical factors associated with in-hospital mortality were identified: elevated serum creatinine (sCr), OR=1.47 [95% CI: 1.23, 1.74] for every point increases above one mg/dl; and low admission systolic blood pressure (SBP), OR=1.54; [95% CI: 1.43, 1.65] for every 10 points decrease in SBP below 140 mmHg. At one-year follow up, mortality was 27%. Independent predictors of one-year mortality were: age, OR=1.47; [95% CI: 1.23,1.75] for every 10-year increase above 40; low discharge SBP, OR=1.30 [95% CI: 1.08, 1.52] for every 10 points decrease below 140 mmHg; low ejection fraction, OR=1.51 [95% CI: 0.59,0.73] for every 5 points decrease from 65%; chronic liver disease, OR=3.0 [95% CI: 1.51,5.88]; history of stroke, OR=3.2 [95% CI: 1.52,6.65]. These variables overlapped with those identified in US registries. Conclusions: Independent clinical variables associated with mortality after HF hospitalization in Egypt are similar to those reported in HF registries in the US.