Pediatric heart failure among emergency room admissions in a Tertiary Health Centre in Southern Nigeria

Abstract

Introduction: Heart failure is a common pediatric emergency. This study was conducted to determine the prevalence and underlying causes of heart failure among children admitted to the Children's Emergency Ward of the Niger Delta University Teaching Hospital Okolobiri, Bayelsa State. Materials and Methods: Over a 1-year period from January 1, 2014 to December 31, 2014; consecutive children presenting to the emergency ward with clinical features of heart failure were recruited. After stabilization and management, a proforma was opened for each patient containing details of the history, physical examination, underlying causes of the heart failure, method of treatment, and outcome. Results: Of the 473 children seen over the study period, 79 of them presented with clinical features of heart failure, accounting for 16.7% of the total pediatric admissions with a male: female ratio of 1.4:1. Their ages ranged from 1½ months to 14 years (mean age 35.3 ± 34.9 months). The major underlying causes of heart failure were anemia (59.5%) and lower respiratory tract infections (21.5%). Severe malaria was the most common cause of anemia. Of the 79 cases, there were 17 deaths (case fatality rate of 21.5%), which accounted for over 50% of the total mortalities in the Children's Emergency room over the study period. Mortality from heart failure was significantly associated with increased severity of heart failure at presentation (P = 0.004; Fishers exact test). Conclusion: Scaling up malaria prevention programs, strengthening immunization practices, prompt recognition and treatment of the underlying causes of heart failure would reduce morbidity and mortality from this easily preventable and treatable condition.