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Factors Predicting Heart Failure in Children Admitted to a Pediatric Emergency Ward in a Developing Country
Onubogu, Uchenna.
  • Onubogu, Uchenna; Rivers State University Teaching Hospital. Port Harcourt. NG
Int. j. cardiovasc. sci. (Impr.) ; 33(6): 673-685, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1143116
ABSTRACT
Abstract Background Heart failure is an important cause of morbidity and mortality in children. Objective To determine the clinical characteristics of children with acute heart failure syndrome in the emergency ward of River state university teaching hospital, Nigeria and identify factors associated with poor outcomes. Methods This was an 18month retrospective review of the acute heart failure register. Poor outcome measures were defined as the persistence of heart failure after 4 days on admission or death. Results Ninety-two (4.1%) of 2,244 children admitted were in heart failure, Non-cardiac disorders [bronchopneumonia 32(36%), sepsis 21(24%), severe malaria 10(11%), sickle cell anaemia 8(9%) and tuberculosis 3(3%)] contributed to 74(83%) while congenital heart disease(CHD) was 15(17%). Seventy-four (83%) were discharged, 10(11%) died and 4(5%) left against medical advice. The median time to resolution of heart failure was significantly 24 hours longer for malnourished children than those with normal-nutritional status, 72Vs48hrs, log rank0.001. Those with modified Ross score of >7 and sepsis were more likely to die, OR,8.8(95% CI,1.2 to 72.5,p = 0.02) and 3.9(95% CI,1.01 to 15.2;p =0.04). Age <2yrs(OR,3.1,CI,1.2 to 8.5,p = 0.02), and CHD (OR 3.6,95% CI,1.1 to 12,P=0.02) were associated with a higher likelihood of having a poor outcome. Each unit increase in weight for age Z score of 1, decreased the odds of having a poor outcome, OR,0.77 (95% CI,0.63 to 0.95)p=0.016. Conclusion Heart failure in our setting is predominantly caused by non-cardiac disorders. Modified Ross score of >7 and sepsis are risk factors for mortality in children with heart failure. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Malnutrition / Heart Failure Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: Africa Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2020 Type: Article Affiliation country: Nigeria Institution/Affiliation country: Rivers State University Teaching Hospital/NG

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Full text: Available Index: LILACS (Americas) Main subject: Malnutrition / Heart Failure Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: Africa Language: English Journal: Int. j. cardiovasc. sci. (Impr.) Journal subject: Cardiology Year: 2020 Type: Article Affiliation country: Nigeria Institution/Affiliation country: Rivers State University Teaching Hospital/NG