Journal of Advances in Medicine and Medical Research | 2021
Factors Associated with Intra-hospital Mortality of Peripartum Cardiomyopathy Patients in Northcentral Nigeria
Abstract
Aims: We studied the patient characteristics, intra-hospital outcomes and factors associated with intra-hospital mortality in patients admitted for Peripartum Cardiomyopathy (PPCM) in our centre using data from the Ilorin Heart failure Registry. Study design: Prospective Observational Methodology: All the 22 confirmed PPCM patients admitted between January 1, 2016 and December 31, 2019 were recruited and followed up for intra-hospital outcomes. The primary outcome was all-cause intra-hospital mortality. Original Research Article Ogunmodede et al.; JAMMR, 33(9): 1-10, 2021; Article no.JAMMR.66819 2 Results: Intra-hospital death occurred in four out of 22 patients (18.2%). The mean age of all patients was 28.4 ± 4.8 years and it was similar in both survivors and patients who died (P=0.960). Majority of patients (14, 63.7%) presented in New York Heart Association Class IV. Mean duration of hospital stay was 11 + 5.7days which was similar between patients who died and those who survived hospital admission (9.0 ± 2.8 vs 11.4 ± 6.1, P=0.457). Median ECG heart rate was 120 (116-123) bpm which was similar between both groups. Factors associated with mortality were biochem ical parameters serum sodium and eGFR which were significantly lower among those who died (125.0 ± 4.1 vs 133.7 ± 2.5mmol/L, P=<0.001; 41.0 ± 18.8 vs 81.9 ± 11.03 mls/min/1.73m 2 , P<0.001) and the Ejection fraction (EF) and Fractional Shortening (FS) which were also significantly lower in the patients who died 24.0 ± 8.2% vs 37.9 ± 6.2%, P=0.002; 11.0 ± 4.3% vs 18.4 ± 3.8, P=0.003 respectively. Other echocardiographic parameters were similar between the two groups of patients. A Kaplan-Meier survival curve was drawn to show the time to outcome. Conclusion: Majority of PPCM patients present in clinically severe heart failure and the intrahospital mortality is high. The importance of serum sodium, eGFR, EF and FS as factors associated with mortality indicates patient sub-groups requiring greater attention and targeted interventions.