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Multicenter Study
. 2025 May 27;25(1):406.
doi: 10.1186/s12872-025-04858-7.

Determinants of readmission amongst hospitalized patients with heart failure in Ghana and Nigeria: a prospective cohort study

Dzifa Ahadzi  1 , Amudalat Issa  2 , Odalys Rivera Hernandez  3 , Olutobi Adekunle Sanuade  4 , Mohammed Baba Abdulkadir  5 , Ernest Yorke  6 , Bamidele Tayo  7
Affiliations
Multicenter Study

Determinants of readmission amongst hospitalized patients with heart failure in Ghana and Nigeria: a prospective cohort study

Dzifa Ahadzi et al. BMC Cardiovasc Disord. .

Abstract

Background: Readmission following hospitalization for acute heart failure (HF) is an adverse prognostic event. Readmission rates for HF in African countries are variable, ranging from 1.53 to 25% in the first 30 days, and 12.2% to over 50% at 180 days. Few studies done in the African region have identified several determinants of HF readmission including New York Heart Association functional class, heart failure phenotype, older age, amongst others. This study sought to explore determinants of readmission amongst a contemporary cohort of adult patients hospitalized with HF in Ghana and Nigeria.

Methods: This was a multicenter prospective cohort study, with 30- and 90-day follow-up after recruitment, conducted from June 2021 to April 2022, in two tertiary teaching hospitals in Ghana and Nigeria. A total of 201 adult patients who presented with acute heart failure at the two study sites were consecutively enrolled.

Results: In this cohort of 201 patients (mean age (SD) 58.8 (15.6) years, 44.3% women), 8.0% and 13.9% were readmitted at 30- and 90-days, respectively. The odds of readmission at 30-days were higher in participants from Nigeria (OR = 4.3, 95% CI - 0.02-0.75, p = 0.039) and those with duration of heart failure diagnosis of 1 month to < 1 year (sub-acute HF) (OR = 4.0, 95% CI - -0.00-0.27, p = 0.045). Every unit increase in pulse rate was associated with almost 5-fold higher odds of readmission at 30-days (OR = 4.7, 95% CI - 0.00-0.01, p = 0.031). The odds of 90-day readmission were higher in participants with New York Heart Association functional class III-IV at discharge (OR = 5.1, 95% CI - -0.03-0.42, p = 0.025).

Conclusion: Heart failure patients with sub-acute HF, higher pulse rates at baseline and higher NYHA functional class at discharge, may represent a vulnerable group at high risk of readmission in Ghana and Nigeria. Future studies should explore the mechanisms underlying this observation and consider interventions to reduce the risk of readmission amongst this unique patient population.

Clinical trial number: Not applicable.

Keywords: Ghana; Heart failure; Nigeria; Readmission.

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Conflict of interest statement

Declarations. Ethics approval: The study was approved by the Institutional Review Board of KBTH (KBTH-IRB/000/2021) and the UITH Health Research Ethics Committee (UITH-ERC/PAN/2021/01/0115). Consent for publication: Written informed consent was obtained after the aims and objectives of the study were thoroughly explained to the patients. All questionnaires were anonymized with a unique identified code known only to the study investigators. Competing interests: The authors declare no competing interests.

References

    1. Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GMC, Coats AJS. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. 2023;118:3272–87. - PubMed
    1. Yan T, Zhu S, Yin X, et al. Burden, trends, and inequalities of heart failure globally, 1990 to 2019: A secondary analysis based on the global burden of disease 2019 study. J Am Heart Assoc. 2023;12:e027852. - PMC - PubMed
    1. Gtif I, Bouzid F, Charfeddine S, Abid L, Kharrat N. Heart failure disease: an African perspective. Arch Cardiovasc Dis. 2021;114:680–90. - PubMed
    1. Akpa MR, Iheji O. Short-term rehospitalisation or death and determinants after admission for acute heart failure in a cohort of African patients in Port Harcourt, Southern Nigeria. Cardiovasc J Afr. 2018;29:46–50. - PMC - PubMed
    1. Appiah LT, Sarfo FS, Agyemang C, Tweneboah HO, Appiah NABA, Bedu-Addo G, Opare-Sem O. Current trends in admissions and outcomes of cardiac diseases in Ghana. Clin Cardiol. 2017;40:783–8. - PMC - PubMed

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