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      The Burden and Contributing Factors of Cardiogenic Pulmonary Edema Among Acute Heart Failure Patients Admitted to Tertiary Hospital, Eastern Ethiopia

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          Abstract

          Background

          Despite cardiogenic pulmonary edema is the most common phenotype of acute heart failure (AHF), studies on its burden and associated factors are limited. This study aimed to assess the burden and contributing factors of cardiogenic pulmonary edema in patients with acute heart failure admitted to a tertiary hospital in eastern Ethiopia.

          Patients and Methods

          An institution-based cross-sectional study was conducted on the medical records (n = 276) of patients with AHF between February 01, 2018, and January 31, 2023. A simple random sampling technique was used to select participants from the study population. Bivariable and multivariable logistic regression analyses were used to assess factors associated with the development of cardiogenic pulmonary edema. A P-value ≤0.05 was considered as statistically significant.

          Results

          The prevalence of cardiogenic pulmonary edema was 47.8% in AHF patients. Rural residence (adjusted odds ratio (AOR),9.54), smoking (AOR,3.17), comorbidity (AOR,2.1), and underlying cardiovascular disease (ischemic heart disease, chronic rheumatic valvular heart disease, and hypertensive heart disease with AOR: 6.71, 8.47, and 12.07, respectively) were significantly associated with the development of cardiogenic pulmonary edema in patients with AHF.

          Conclusion

          Nearly half of the patients with AHF had cardiogenic pulmonary edema. Being a rural dweller, cigarette smoking, comorbidities, and underlying cardiac illness were significantly associated with the development of cardiogenic pulmonary edema in patients with AHF.

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          Most cited references34

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          2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

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            EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population.

            The objective of the EuroHeart Failure Survey II (EHFS II) was to assess patient characteristics, aetiology, treatment, and outcome of acute heart failure (AHF) in Europe in relation to the guidelines on the diagnosis and treatment of AHF published by the European Society of Cardiology. Patients hospitalized for AHF were recruited by 133 centres in 30 European countries. Three thousand five hundred and eighty patients were entered into the database by the end of August 2005. Mean age was 70 years, and 61% of patients were male. New-onset AHF (de novo AHF) was diagnosed in 37%, of which 42% was due to acute coronary syndromes (ACS). Clinical classification according to the guidelines divided AHF patients into (i) decompensated HF (65%), (ii) pulmonary oedema (16%), (iii) HF and hypertension (11%), (iv) cardiogenic shock (4%), and (v) right HF (3%). Coronary heart disease, hypertension, and atrial fibrillation were the most common underlying conditions. Arrhythmias, valvular dysfunction, and ACS were each present as precipitating factor in one-third of cases. Preserved left ventricular ejection fraction (> or =45%) was observed in 34%. Valvular disorders were common, especially mitral regurgitation (MR) which was reported on echocardiography in 80% of patients. Median length of stay was 9 days, and in-hospital mortality 6.7%. At discharge, 80% of patients were on angiotensin-converting enzyme-inhibitors or angiotensin receptor blockers, whereas 61% were taking beta-blocker medication. Decompensated HF is the most common clinical presentation of AHF patients. More than one-third of AHF patients do not have a previous history of HF, and new-onset HF is often caused by ACS. Preserved systolic function is found in a substantial proportion of the patients. The prevalence of valvular dysfunction is strikingly high and contributes to the clinical presentation. The EHFS II on AHF verified that the use of evidence-based HF medication was well adopted to clinical practice.
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              Heart disease and stroke statistics--2013 update: a report from the American Heart Association.

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                Author and article information

                Journal
                Open Access Emerg Med
                Open Access Emerg Med
                oaem
                Open Access Emergency Medicine : OAEM
                Dove
                1179-1500
                09 November 2023
                2023
                : 15
                : 405-414
                Affiliations
                [1 ]Department of Pharmaceutics, School of Pharmacy, Haramaya University , Harar, Ethiopia
                [2 ]Department of Clinical Pharmacy, School of Pharmacy, Haramaya University , Harar, Ethiopia
                [3 ]Department of Pharmacology, School of Pharmacy, Haramaya University , Harar, Ethiopia
                [4 ]Department of Emergency and Critical Care Medicine, School of Medicine, College of Health and Medical Sciences, Haramaya University , Harar, Ethiopia
                Author notes
                Correspondence: Melaku Getachew, Department of Emergency and critical care medicine, School of Medicine, College of Health and Medical Sciences, Haramaya University , P.O. Box: 138, Harar, Ethiopia, Tel +251953137119, Email melakug02@gmail.com
                Author information
                http://orcid.org/0000-0001-8727-8950
                http://orcid.org/0000-0003-0215-3847
                http://orcid.org/0000-0001-6673-9826
                http://orcid.org/0000-0002-3222-1049
                http://orcid.org/0000-0002-4419-739X
                http://orcid.org/0000-0002-1816-2484
                Article
                436352
                10.2147/OAEM.S436352
                10642536
                1ceb18ee-5406-4633-95ff-48ad19e2c36a
                © 2023 Degefu et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 24 August 2023
                : 01 November 2023
                Page count
                Figures: 1, Tables: 3, References: 34, Pages: 10
                Funding
                Funded by: funding;
                There is no funding to report.
                Categories
                Original Research

                acute heart failure,cardiogenic pulmonary edema,ethiopia,tertiary hospital

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