In-hospital outcome and its predictors among patients with acute cardiogenic pulmonary oedema at a tertiary hospital in Harar, Eastern Ethiopia: a retrospective cohort study

ABSTRACT

Background:

Acute cardiogenic pulmonary oedema is highly associated with poor in-hospital outcomes. This study aimed to determine the in-hospital outcome and its predictors among patients with acute cardiogenic pulmonary oedema at a tertiary hospital in Harar, Eastern Ethiopia, from May 1 to 20, 2023.

Methods:

A retrospective cohort study was employed among 204 patients with acute cardiogenic pulmonary oedema who were admitted between 1st May 2018 and 30th April 2023. The collected data were entered into Excel, and analysed using theSTATA software version 17. The hazard ratio with its 95% confidence interval was used and a P-value < 0.05 was considered a statistically significant association.

Results:

The overall mortality rate was 17.60 (95% CI: 11.59–26.72) per 1000 person-day observation with mean (±SD) time to death was 2.88 (±2.06) days. Age (AHR: 1.35; 95% CI: 1.04–1.74 for every 10 years), being smoker (AHR: 3.26; 95% CI: 1.05–10.10), having respiratory rate of ≥40 breaths per minute (AHR: 5.46; 95% CI: 1.71–17.45), and having anaemia (AHR: 4.35; 95% CI: 1.23–15.33) were significant predictors of in-hospital mortality.

Conclusion:

More than one in ten patients in this study died in the hospital. Therefore, special attention needs to be considered for patients with those predictors of in-hospital mortality.

KEYWORDS:

• Acute cardiogenic pulmonary oedema
• In-hospital outcome
• Eastern Ethiopia

Acknowledgements

The authors would like to thank Haramaya University, HFCSH, for the cooperation during protocol approval and data collection of the study. Also, their gratitude is extended to HFCSH administrators and card room staff members for their cooperation during data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

All authors contributed to the conception, designation of the study, supervision of data collection, data analysis and interpretation, drafting or revising the article, agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.

Ethical approval and consent to participate

Ethical approval was obtained from the Institutional Health Research Ethics Review Committee (IHRERC) of the Haramaya University College of Health and Medical Sciences with a reference number of IHRERC/196/2022. Informed, voluntary, written, and signed consent was obtained from each hospital head. Confidentiality was maintained, and the names and unique identifiers of the patients were not included in the data abstraction format. As this study is a retrospective medical record review, consent from patients was not needed.

Data availability statement

Data will be available from the corresponding author upon request.

Additional information

Funding

The authors did not receive any funds for this study.

Notes on contributors

Natanim Degefu

Natanim Degefu, an assistant professor of Pharmaceutics at School of Pharmacy College of Health and Medical Sciences, Haramaya University. Among her recent publications: ‘Emergency department overcrowding and its associated factors at HARME medical emergency center in Eastern Ethiopia', and ‘In-hospital mortality and length of stay of patients with hypertensive crisis treated at public hospitals in Harari Regional State, Eastern Ethiopia’.

Abera Jambo

Abera Jambo, a lecturer at School of Pharmacy College of Health and Medical Sciences, Haramaya University. Among his recent publications: ‘COVID-19 vaccine acceptance, use, and associated factors among health sciences students in Eastern Ethiopia', ‘Seizure Remission and Its Predictors Among Epileptic Patients on Follow-up at Public Hospitals in Eastern Ethiopia: A Retrospective Cohort Study', and ‘The Magnitude of Hypertension and Its Contributing Factors Among Patients Receiving Antiretroviral Therapy in Public Hospitals in Harar City, Eastern Ethiopia: A Cross-Sectional Study’.

Lemma Demissie Regassa

Lemma Demissie Regassa, an assistant professor at School of Public Health, College of Health and Medical Sciences Haramaya University. Currently, a PhD student at London School of Hygiene and tropical medicine in infectious disease epidemiology, with a primary focus on the epidemiology and policy of meningococcal disease. Among his recent publications: ‘The burdens, associated factors, and reasons for traditional uvulectomy in Ethiopia: A systematic review and meta-analysis', and ‘In-hospital mortality and length of stay of patients with hypertensive crisis treated at public hospitals in Harari Regional State, Eastern Ethiopia’.

Melaku Getachew

Melaku Getachew, an assistant professor of emergency and critical care medicine at School of Medicine, College of Health and Medical Sciences Haramaya University. Among his recent publications: ‘Emergency department overcrowding and its associated factors at HARME medical emergency center in Eastern Ethiopia', and ‘In-hospital mortality and length of stay of patients with hypertensive crisis treated at public hospitals in Harari Regional State, Eastern Ethiopia’.