Predictors of mortality and morbidity in acute decompensated heart failure in diabetics in Morrocco

Abstract

Heart failure is a common reason for emergency room admissions. A major public health problem, it is associated with high morbidity and mortality despite a high variety of therapies. The clinical complexity of the presentations essentially depends on the various incriminated risk factors, in particular the presence of diabetes. Several studies have evaluated the relationship between acute heart failure and diabetes. The aim of this study is to evaluate the predictors of morbidity and mortality in diabetics with acute decompensated heart failure in our Moroccan context. This is a retrospective study including patients hospitalized in the cardiology department of the Ibn Rochd University Hospital in Casablanca, for acute decompensated heart failure from January 2017 to December 2020. The median age is 62.7 ± 10.4 years old. Sex ratio is 1.43. The three main triggers of cardiac decompensation in diabetics were the onset of coronary syndrome (35.9%), followed by infection (25.6%) and then deviation from diet (15.4%). 53.8% of the patients were not followed for chronic heart failure. Diabetes was significantly associated with overall mortality [risk ratio [HR] 1.24, 95% confidence interval (CI) 0.95–1.17]. The following parameters have been identified as being the predictors of hospital mortality in diabetic patients admitted for acute heart failure: advanced age, triggering factor: ischemia, systolic blood pressure < 90 mmHg, Hyperglycemia on admission, left ventricular fraction ejection (LVEF) < 50%, hyponatremia on admission and worsening of renal function during hospitalization. Acute heart failure, especially in diabetics, remains a common cause of emergency room admissions and characterized by a high rate of mortality and morbidity. The identification of predictors of mortality and morbidity makes it possible to stratify the population at risk in order to ensure more rigorous care.