Causes of hospital readmission with heart failure at Muhimbili National hospital: Tanzanian experience

Abstract

Background: Readmission rates for patients discharged with heart
failure approaches fifty percent within six months. Identifying factors causing re-admissions in these patients would help clinicians
to strategise ways to reduce the need for hospitalization.
Broad Objectives: To study the demographic characteristics,
underlying , precipitating and facilitating causes among patients readmitted with heart failure. Also to identify problems faced by the
patients in the follow up programme.
Study Design: Descriptive prospective case study.
Study Setting: Muhimbili National Hospital, Dar-es-Salaam,
Tanzania.
Measure of Outcome: Identify causes leading to re-admission among
patients with heart failure.
Subject: Ninety seven consecutive patients re-admitted in the medical
wards with heart failure.
Interventions: A detailed medical history, clinical examination, blood
tests, ECG and echocardiographic evaluation were performed.
Results: A total of 97 patients [56 females and 41 males] were
studied. Their mean age was 39.5 years with a range of 8 to 76 years.
The major underlying clinical causes for readmission were:
cardiomyopathies, hypertensive heart disease, rheumatic heart
disease and pericardial disease. The common precipitating causes for
readmission were: infections, anaemia hypertension and
arrhythmias. The important facilitating causes were: inadequate
medical treatment, poor compliance inadequate follow up and poor
knowledge of the patients.
Conclusion: Extra efforts should be made by the clinicians and
health care providers in improving their prescription habits as well
as educating the patients about their disease, compliance and risk
factor for cardiovascular disease so as to reduce readmissions.

Keywords:  Heart failure, Muhimbili Tanzania