In-Hospital Prevalence of Heart Failure and Etiologic Factors at Monkole Hospital, Kinshasa, Democratic Republic of the Congo: A Retrospective Study of Medical Admissions during One Year of Observation
Background and Objectives: In Kinshasa, the capital city of the Democratic Republic of the Congo and the largest and most populous city in Central Africa, the in-hospital prevalence of heart failure is currently unknown. This study sought to determine the in-hospital prevalence of heart failure among adult patients diagnosed with a cardiovascular disease in Kinshasa. Methods: We reviewed all cardiovascular diagnoses recorded on Excel spreadsheets for adult patients admitted at Monkole Hospital between January 1, 2019, and December 31, 2019. We calculated the prevalence of heart failure diagnosis and of cardiovascular comorbidities, and we determined the odds of a heart failure diagnosis in association with cardiovascular comorbidities using logistic regression analyses. Results: Of 442 patients aged ≥ 18 years diagnosed with a cardiovascular disease at the hospital in 2019, 145 (32.8%) were diagnosed with heart failure, 97 (21.9%) were diagnosed with hypertensive heart disease, 85 (19.2%) were diagnosed with ischemic heart disease, 40 (9.0%) were diagnosed with pulmonary embolism, 32 (7.2%) were diagnosed with arrhythmia, 22 (5.0%) were diagnosed with hypertension, and 20 (4.5%) were diagnosed with cardiomyopathy. Independent predictors of a heart failure diagnosis were age ≥ 65 (adjusted odds ratio [AOR]: 3.62; 95% CI: 2.04 - 6.42), a diagnosis of ischemic heart disease (AOR: 4.17; 95% CI: 2.19 - 7.96), a diagnosis of pulmonary embolism (AOR: 6.91; 95% CI: 2.55 - 18.7), a diagnosis of hypertensive heart disease (AOR: 2.44; 95% CI: 1.37 - 4.35), age 50 to 64 (AOR: 1.90; 95% CI: 1.13 - 3.20), a diagnosis of arrhythmia (AOR: 32.1; 95% CI: 4.26 - 242.0), and a diagnosis of hypertension (AOR: 9.06; 95% CI: 1.99 - 41.2). Conclusions: Heart failure was the most frequent diagnosis among all adult patients diagnosed with a cardiovascular disease at Monkole Hospital in 2019. The one-year in-hospital heart failure prevalence of 32.8% we report is higher than the 25.6% to 42.5% in-hospital heart failure prevalences observed during 2 to 4 years in tertiary care facilities in Cameroon, Nigeria, and Togo.
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