The spectrum, prevalence and in-hospital outcomes of cardiovascular diseases in a South African district hospital: a retrospective study.

INTRODUCTION The increasing prevalence of cardiovascular risk factors in South African rural communities is well reported. However, the prevalence of cardiovascular disease (CVD) leading to hospital admission and related in-hospital mortality in rural and semi-rural hospitals is unknown. METHODS We conducted a retrospective review of hospital records for patients admitted to the Department of Internal Medicine at Dora Nginza Hospital in Port Elisabeth, South Africa between 1 April and 31 October 2016. The study focused on patients who received a primary diagnosis of CVD. RESULTS During the seven-month study period, 4 884 patients were admitted to the unit, 1 325 of whom received a primary diagnosis of CVD, giving a prevalence of 27%. Patients with CVD had a mean (standard deviation) age of 60 (± 15) years, 32% of this patient population was younger than 55 years and 65% were female. Furthermore, 94% had a background medical history of systemic hypertension and 30% of diabetes mellitus. The three leading cardiovascular causes of hospital admission were stroke (38%), hypertensive heart disease plus heart failure (33%), and hypertensive emergency/urgency (18%). In-hospital outcome: 12.4% of patients admitted for CVD died during the index hospitalisation and strokes were responsible for 70% of the deaths. CONCLUSIONS The prevalence of CVD in this cohort was high and accounted for significant morbidity and mortality. Systemic hypertension was a leading risk factor in our cohort and we need to intensify efforts to diagnose and treat systemic hypertension.