Cargando…

Types and Outcomes of Arrhythmias in a Cardiac Care Unit in Western Kenya: A Prospective Study

BACKGROUND: Sustained arrhythmias are frequently encountered in cardiac care units (CCU), but their types and outcomes in Africa are unknown. Studies from high-income countries suggest arrhythmias are associated with worse outcomes. OBJECTIVES: To determine the types and proportion of cardiac arrhyt...

Descripción completa

Detalles Bibliográficos
Autores principales: Kiyeng, Joan, Akwanalo, Constantine, Sugut, Wilson, Barasa, Felix, Mwangi, Ann, Njuguna, Benson, Siika, Abraham, Vedanthan, Rajesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ubiquity Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516140/
https://www.ncbi.nlm.nih.gov/pubmed/37744209
http://dx.doi.org/10.5334/gh.1261
_version_ 1785109077511110656
author Kiyeng, Joan
Akwanalo, Constantine
Sugut, Wilson
Barasa, Felix
Mwangi, Ann
Njuguna, Benson
Siika, Abraham
Vedanthan, Rajesh
author_facet Kiyeng, Joan
Akwanalo, Constantine
Sugut, Wilson
Barasa, Felix
Mwangi, Ann
Njuguna, Benson
Siika, Abraham
Vedanthan, Rajesh
author_sort Kiyeng, Joan
collection PubMed
description BACKGROUND: Sustained arrhythmias are frequently encountered in cardiac care units (CCU), but their types and outcomes in Africa are unknown. Studies from high-income countries suggest arrhythmias are associated with worse outcomes. OBJECTIVES: To determine the types and proportion of cardiac arrhythmias among patients admitted to the CCU at Moi Teaching and Referral Hospital (MTRH), and to compare 30-day outcomes between patients with and without arrhythmias at the time of CCU admission. METHODS: We conducted a prospective study of a cohort of all patients admitted to MTRH-CCU between March and December 2021. They were stratified on the presence or absence of arrhythmia at the time of CCU admission, irrespective of whether it was the primary indication for CCU care or not. Clinical characteristics were collected using a structured questionnaire. Participants were followed up for 30 days. The primary outcome of interest was 30-day all-cause mortality. Secondary outcomes were 30-day all-cause readmission and length of hospital stay. The 30-day outcomes were compared between the patients with and without arrhythmia, with a p value < 0.05 being considered statistically significant. RESULTS: We enrolled 160 participants. The median age was 46 years (IQR 31, 68), and 95 (59.4%) were female. Seventy (43.8%) had a diagnosis of arrhythmia at admission, of whom 62 (88.6%) had supraventricular tachyarrhythmias, five (7.1%) had ventricular tachyarrhythmias, and three (4.3%) had bradyarrhythmia. Atrial fibrillation was the most common supraventricular tachyarrhythmia (82.3%). There was no statistically significant difference in the primary outcome of 30-day mortality between those who had arrhythmia at admission versus those without: 32.9% versus 30.0%, respectively (p = 0.64). CONCLUSION: Supraventricular tachyarrhythmias were common in critically hospitalized cardiac patients in Western Kenya, with atrial fibrillation being the most common. Thirty-day all-cause mortality did not differ significantly between the group admitted with a diagnosis of arrhythmia and those without.
format Online
Article
Text
id pubmed-10516140
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Ubiquity Press
record_format MEDLINE/PubMed
spelling pubmed-105161402023-09-23 Types and Outcomes of Arrhythmias in a Cardiac Care Unit in Western Kenya: A Prospective Study Kiyeng, Joan Akwanalo, Constantine Sugut, Wilson Barasa, Felix Mwangi, Ann Njuguna, Benson Siika, Abraham Vedanthan, Rajesh Glob Heart Original Research BACKGROUND: Sustained arrhythmias are frequently encountered in cardiac care units (CCU), but their types and outcomes in Africa are unknown. Studies from high-income countries suggest arrhythmias are associated with worse outcomes. OBJECTIVES: To determine the types and proportion of cardiac arrhythmias among patients admitted to the CCU at Moi Teaching and Referral Hospital (MTRH), and to compare 30-day outcomes between patients with and without arrhythmias at the time of CCU admission. METHODS: We conducted a prospective study of a cohort of all patients admitted to MTRH-CCU between March and December 2021. They were stratified on the presence or absence of arrhythmia at the time of CCU admission, irrespective of whether it was the primary indication for CCU care or not. Clinical characteristics were collected using a structured questionnaire. Participants were followed up for 30 days. The primary outcome of interest was 30-day all-cause mortality. Secondary outcomes were 30-day all-cause readmission and length of hospital stay. The 30-day outcomes were compared between the patients with and without arrhythmia, with a p value < 0.05 being considered statistically significant. RESULTS: We enrolled 160 participants. The median age was 46 years (IQR 31, 68), and 95 (59.4%) were female. Seventy (43.8%) had a diagnosis of arrhythmia at admission, of whom 62 (88.6%) had supraventricular tachyarrhythmias, five (7.1%) had ventricular tachyarrhythmias, and three (4.3%) had bradyarrhythmia. Atrial fibrillation was the most common supraventricular tachyarrhythmia (82.3%). There was no statistically significant difference in the primary outcome of 30-day mortality between those who had arrhythmia at admission versus those without: 32.9% versus 30.0%, respectively (p = 0.64). CONCLUSION: Supraventricular tachyarrhythmias were common in critically hospitalized cardiac patients in Western Kenya, with atrial fibrillation being the most common. Thirty-day all-cause mortality did not differ significantly between the group admitted with a diagnosis of arrhythmia and those without. Ubiquity Press 2023-09-21 /pmc/articles/PMC10516140/ /pubmed/37744209 http://dx.doi.org/10.5334/gh.1261 Text en Copyright: © 2023 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Research
Kiyeng, Joan
Akwanalo, Constantine
Sugut, Wilson
Barasa, Felix
Mwangi, Ann
Njuguna, Benson
Siika, Abraham
Vedanthan, Rajesh
Types and Outcomes of Arrhythmias in a Cardiac Care Unit in Western Kenya: A Prospective Study
title Types and Outcomes of Arrhythmias in a Cardiac Care Unit in Western Kenya: A Prospective Study
title_full Types and Outcomes of Arrhythmias in a Cardiac Care Unit in Western Kenya: A Prospective Study
title_fullStr Types and Outcomes of Arrhythmias in a Cardiac Care Unit in Western Kenya: A Prospective Study
title_full_unstemmed Types and Outcomes of Arrhythmias in a Cardiac Care Unit in Western Kenya: A Prospective Study
title_short Types and Outcomes of Arrhythmias in a Cardiac Care Unit in Western Kenya: A Prospective Study
title_sort types and outcomes of arrhythmias in a cardiac care unit in western kenya: a prospective study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516140/
https://www.ncbi.nlm.nih.gov/pubmed/37744209
http://dx.doi.org/10.5334/gh.1261
work_keys_str_mv AT kiyengjoan typesandoutcomesofarrhythmiasinacardiaccareunitinwesternkenyaaprospectivestudy
AT akwanaloconstantine typesandoutcomesofarrhythmiasinacardiaccareunitinwesternkenyaaprospectivestudy
AT sugutwilson typesandoutcomesofarrhythmiasinacardiaccareunitinwesternkenyaaprospectivestudy
AT barasafelix typesandoutcomesofarrhythmiasinacardiaccareunitinwesternkenyaaprospectivestudy
AT mwangiann typesandoutcomesofarrhythmiasinacardiaccareunitinwesternkenyaaprospectivestudy
AT njugunabenson typesandoutcomesofarrhythmiasinacardiaccareunitinwesternkenyaaprospectivestudy
AT siikaabraham typesandoutcomesofarrhythmiasinacardiaccareunitinwesternkenyaaprospectivestudy
AT vedanthanrajesh typesandoutcomesofarrhythmiasinacardiaccareunitinwesternkenyaaprospectivestudy