Multimorbidity and predictors of mortality among patients with cardiovascular disorders admitted to an intensive care unit: a retrospective study

Abstract

Abstract

Background: Prevalence of cardiovascular risk factors is reported to be increasing in Ethiopia. Multimorbidity of these risk factors is more likely to lead cardiovascular disease (CVD) with increased hospital admission, premature death, and poor quality of life and increase health care expenditure. There is little evidence regarding magnitude and outcome of CVD multimorbidity, particularly in the African setting. The aim of this study was to examine the magnitude of multimorbidity and predictors of mortality in patients with cardiovascular disease admitted to the Medical Intensive Care Unit of St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Results: A total of 71 (19.6%) patients had a diagnosis of multimorbidity. The most common cases of cardiovascular admission were heart failure, 137 (37.8%), acute myocardial infarction, 83 (22.9%), hemorrhagic stroke, 95 (26.2%) and ischemic stroke, 24 (6.6%).There were 162 (45%) deaths. Myocardial infarction (COR 0.3; 0.18-0.53), hemorrhagic stroke (COR 3.3; 2.0-5.5) and age groups 55-64 years (COR 2.7; 1.2-6.1) and 65-74 years (COR 2.6; 1.1-6.1) were significantly associated with mortality.

Conclusions: There is a significant proportion of multimorbidity in our study population. Multimorbidity may be used as a criterion to prioritize and improve the management of patients. Measures to prevent cardiovascular disease in people who already have hypertension, diabetes or underlying causes of heart failure in primary care settings need to be emphasized At higher levels of care, capacity building is key to addressing the management of patients who present with acute cardiovascular diseases.  [Ethiop. J. Health Dev. 2018;32(4):218-224]

Keywords: Cardiovascular disease, multimorbidity, mortality, intensive care