Survival During Treatment Period of Patients with Severe Heart Failure Admitted to Intensive Care Unit (ICU) at Gondar University Hospital (GUH), Gondar, Ethiopia

Heart failure (HF) is progressive and irreversible which occurs more slowly because of damage to the heart muscle, building up through time due to disease of the heart or a blood vessel leading from the heart as a result of various diseases. In nearly all regions of the world HF is both common and increasing. Predictions for the next two decades include tripling of heart disease and stroke mortality in Latin America, the Middle East, and even sub-Saharan Africa. This study is an attempt to study the survival during treatment period of severe heart failure patients admitted to intensive care unit(ICU) ward at Gondar University Hospital(GUH). Data were collected from 147 severe heart failure patients admitted to the ICU ward of Gondar University Hospital, Gondar, Ethiopia during January 2012- June 2014. Non-parametric, semi-parametric PH, parametric PH and AFT models were used for data analysis. Different statistical techniques were used to compare performances of semi-parametric PH, parametric PH and AFT models. Descriptive statistical results show that predominant causes of HF were coronary heart disease and valvular heart disease which causes 38.1% and 29.9% of the total population respectively. In this study (26.09%) of the deaths were attributed to respiratory failure, (15.22%) due to cardiac arrest (15.22%) multi-organ failure, (10.87%) end stage renal failure. The variables “History of HF”, “Duration of HF”, and “Department the patient seen at first” were found to be significant predictors of the survival during treatment period of patients with severe heart failure admitted to ICU ward by the multivariable Cox PH model and the multivariable exponential and Weibull PH, and multivariate Log-Logistic AFT models. The Cox PH model was a better fit than the other models. Being seen at chronic illness follow-up first, diagnosed as patient with heart failure for the first time and lower number of years stay with heart failure significantly decrease hazard of in-ICU mortality. Special attention to patients discharged from emergency department, diagnosed as patient with heart failure before current admission, with higher number of years stay with heart failure, advanced age and with comorbidity condition coronary artery disease is recommended as possible interventions to improve in-ICU survival of patients with severe HF.