Abstract

Objectives: Heart failure (HF) poses a significant global health burden, characterized by inadequate cardiac output and systemic organ dysfunction. This study aimed to compare in-hospital outcomes between patients with reduced (HFrEF) and preserved (HFpEF) ejection fraction presenting with congestive heart failure. Methodology: A cross-sectional, prospective study was conducted at the Department of Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan, from July 2022 to January 2023. Patients aged 35 to 80 years with congestive heart failure were included. Ejection fraction status, demographic data, and clinical parameters were assessed, with in-hospital mortality as the primary outcome. Results: Among 196 patients, 91 (46.4%) had HFrEF, and 105 (53.6%) had HFpEF. In-hospital mortality occurred in 23 (11.7%) patients. Mortality rates were significantly higher in HFrEF patients compared to HFpEF patients (17.6% vs. 6.7%, p=0.018). Age (>60 years) and diabetes mellitus were significantly associated with in-hospital mortality (p=0.001 and p=0.036, respectively). Conclusion: This study highlights significantly higher in-hospital mortality rates in patients with reduced ejection fraction compared to preserved ejection fraction, underscoring the importance of considering ejection fraction status in assessing prognosis and guiding management strategies for patients with congestive heart failure.

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