Modifiable predictors of severe heart failure in Morocco: a descriptive study using routinely collected health data

Heart Failure (HF) is a growing public health concern in Morocco and there is a striking paucity on determinants of severe HF (SHF) in this population. The aim of this study was to identify patients admitted with HF at Ibn Rochd Hospital, Casablanca from 2011 onwards, when electronic record keeping...

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Bibliographic Details
Published in:	The Pan African medical journal Vol. 34; no. 6; p. 6
Main Authors:	Kone, Alpha, Cherif, Mahamoud Sama, Prabin, Dahal, Dumre, Shyam Prakash, Doumbouya, Almamy Ibrahim, Kapche, Diane Fotso, Camara, Facely, Saousan, Serbout, Sara, Khaddi, Diakite, Mandiou, Cisse, Mohamed, Azzouzi, Leila, Habbal, Rachida
Format:	Journal Article
Language:	English
Published:	Uganda African Field Epidemiology Network 2019 The African Field Epidemiology Network The Pan African Medical Journal
Subjects:	Aged Aneurysms Angina pectoris Biomarkers Biomarkers - metabolism Blood pressure Cardiology Case management Classification Clinical decision making Clinical medicine Decision making Diabetes Disease Electronic Health Records Estimates Female hdl Health facilities Heart failure Heart Failure - epidemiology Heart Failure - physiopathology Hemoglobins - metabolism Hospitalization Hospitals Humans Inflammation Lipoproteins Lymphocytes Lymphocytes - metabolism Male Medical prognosis Medicine Middle Aged Morocco Neutrophils Neutrophils - metabolism neutrophils-lymphocytes-ratio Pharmacy Risk Factors Severity of Illness Index Morocco Heart failure hdl Morocco neutrophils-lymphocytes-ratio
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Summary:	Heart Failure (HF) is a growing public health concern in Morocco and there is a striking paucity on determinants of severe HF (SHF) in this population. The aim of this study was to identify patients admitted with HF at Ibn Rochd Hospital, Casablanca from 2011 onwards, when electronic record keeping began. A total of 105 patients underwent a series of cardiological examinations between July 2011 and January 2014. The New York Heart Association (NYHA) criteria was used to evaluate the severity of HF. Patients with NYHA classification gradings of I and II were defined as having moderate HF (MHF) and those graded as III and IV were defined as having a SHF. Univariable and multivariable risk factors associated with SHF were explored using logistic regression. The results were reported following the RECORD (Reporting of studies Conducted using Observational Routinely-collected Data) statement. A total of 24 (33%) patients were identified as having a SHF. Four predictors of SHF were identified in univariate analysis: haemoglobin <12g/dL, neutrophil-to-lymphocyte ratio (NLR) >3, mean corpuscular haemoglobin concentration (MCHC) <32 picolitre, and high density lipoprotein (HDL) <0.35 (mmol/L). Only NLR>3 and HDL <0.35 mmol/L remained independent predictors in multivariable analysis. Patients with NLR >3 were at 6-fold increased odds of SHF [adjusted odds ratio (AOR): 6.78, 95% confidence interval (CI): 1.40-32.80, p=0.017], and those with HDL<0.35 (mmol/L) were at 10-fold increased odds of SHF [AOR: 10.11, 95% CI: 2.26-45.27, p=0.002]. The independent biomarkers of SHF identified in this study provide valuable information to ward clinicians in resource-constrained facilities to identify patients vulnerable to developing severe heart complications.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1937-8688 1937-8688
DOI:	10.11604/pamj.2019.34.6.17998