Helal AhmedCommunity Based Medical College & Hospital, Bangladesh
Title: Pulmonary hypertension in the developing world: Local registries, challenges, and ways to move forward
Introduction: The prognosis of chronic heart failure (CHF) is determined by the complex relationship of neurohormonal, mechanical and polyorgan pathological changes emerging in the course and progression of the disease.
Objective: To assess the risk and rate of rehospitalisation due to decompensation of chronic heart failure (CHF) in relation to certain biologic, clinical and instrumental characteristics.
Material and Methods: This study conducted in the Department of Cardiology, Community Based Medical College & Hospital, Bangladesh. Prospective study on 228 consecutive CHF patients. The follow-up period was 12 to 24 months. The primary endpoint was rehospitalization due to HF decompensation. The risk values were calculated using the Cox regression models.
Results: Median survival time was 8 months. The total number of rehospitalizations was 86 (37.7%). Rehospitalization risk values were insignificantly lower in women (HR 0.7, 95% CI 0.4-1.1, ? >0.05) and higher in older age groups (HR 1.4 95% CI 0.8-2.2, ?>0.05). Univariate regression analysis showed a higher rehospitalization risk in patients with survived myocardial infarction, clinical signs of CHF, high functional class and pulmonary pressure. Multivariate regression analyses revealed the leading role of functional class on rehospitalization risk.
Conclusion: Rehospitalization rates due to decompensation of CHF are high. Age and gender are insignificant predictors for rehospitalization in our study. Functional class is the prognostic factor with an independent effect on rehospitalization risk over the defined follow-up period among the examined group of patients.