Follow up from the Lebanese Heart Failure Snapshot: Reflection of geopolitical instability

• Published in: Journal of nursing scholarship Vol. 54; no. 3; pp. 296 - 303
• Main Authors: Deek, Hiba, Davidson, Patricia M
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-05-2022
• Subjects: Activities of daily living; Blood pressure; Clinical outcomes; Coronaviruses; COVID-19; Data collection; Developing countries; Geopolitics; Health care; Health care expenditures; Heart failure; Hospitalization; LDCs; Length of stay; Medical supplies; Mortality; Mortality rates; Occupational roles; Pandemics; Patient admissions; Population; Readmission; Rhythm; Sociocultural factors; Lebanon; mortality; COVID-19 pandemic; heart failure; nursing; readmission
• ISSN: 1527-6546; 1547-5069
• DOI: 10.1111/jnu.12737

Heart failure has a great cost on the health care system. The readmission and mortality rates and their predictors are greatly affected by political and sociocultural unrests.
To determine the readmission and mortality rates and their predictors in heart failure population in times of political and sociocultural unrests.
A cross-sectional follow-up with patients recruited for the Lebanese Heart Failure Snapshot was conducted over the month of June in 2019.
Phone calls were conducted at 30-90 days, 6-12 months following hospital discharge for patient previously admitted to one of the study hospitals for heart failure exacerbation. Follow-up data was conducted from July 2019 till May 2020.
The mean age of the 120 participants was 71 years with a mean ejection fraction of 41%. The 30-90 days, 6-12 months readmission rates were 20%, 56%, 75%, and 78%, respectively. Readmission predictors were non-sinus rhythm and low diastolic blood pressure at admission. Mortality rates at 30-90 days, 6-12 months were 7%, 11%, 17%, and 28%, respectively. Low diastolic blood pressure and longer length of hospital stay were associated with mortality.
The rapid changes in the country make it difficult to formulate an intervention plan. This was seen in the increased rates of readmission and the decreased rates of mortality. Rigorous research should be conducted at every phase of the sociocultural changes in developing countries that were hit by the COVID-19 pandemic and had their economy largely affected.
The occurrences of the countries can greatly influence the outcomes of patients with heart failure. This is true in developing countries that were affected by the COVID-19 pandemic socially, economically, and politically. Research should be done regularly to establish the effect of these changes on patients with heart failure. Nevertheless, nursing roles are the common denominator that should be adapted to all the changes and provided despite all challenges to assure improved outcomes. Such practices include discharge education tailored to the subjective needs of the patients and continuous, uninterrupted follow-up despite of all the occurrences. These practices are likely to decrease adverse outcomes in patients with heart failure.