Symptoms and Signs of Heart Failure at Admission and Discharge and Outcomes in the Sub-Saharan Acute Heart Failure (THESUS-HF) Registry.
BACKGROUND
Symptoms and signs of heart failure (HF) are the most common reasons for admission to hospital for acute HF (AHF) and are used routinely throughout admission to assess the severity of disease and response to therapy.


RESULTS
The data were collected in The Sub-Saharan Africa Survey on Heart Failure (THESUS-HF) study, a prospective, multicenter, observational survey of AHF from 9 countries in sub-Saharan Africa. A total of 1006 patients, ≥12 years of age, hospitalized for AHF were recruited. Symptoms and signs of HF and changes in dyspnea and well-being, relative to admission, were assessed at entry and on days 1, 2, and 7 (or on discharge if earlier) and included oxygen saturation, degree of edema and rales, body weight, and level of orthopnea. The patient determined dyspnea and general well-being, whereas the physician determined symptoms and signs of HF, as well as improvements in vital sign measurement, throughout the admission. After multivariable adjustment, baseline rales and changes to day 7 or discharge in general well-being predicted death or HF hospitalization through day 60, and baseline orthopnea, edema, rales, oxygen saturation, and changes to day 7 or on discharge in respiratory rate and general well-being were predictive of death through day 180.


CONCLUSIONS
In AHF patients in sub-Saharan Africa, symptoms and signs of HF improve throughout admission, and simple assessments, including edema, rales, oxygen saturation, respiratory rate, and asking the patient about general well-being, are valuable tools in patients' clinical assessment.
Department of Medicine, Bayero University Kano/Aminu Kano Teaching Hospital, Kano, Nigeria. Electronic address: sanimahmoud@yahoo.com.
Mahmoud U
MU
Sani
Momentum Research, Durham, North Carolina, United States.
Gad
G
Cotter
Momentum Research, Durham, North Carolina, United States.
Beth A
BA
Davison
Department of Medicine, GF Jooste and Groote Schuur Hospitals, University of Cape Town, Cape Town, South Africa.
Bongani M
BM
Mayosi
Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
Albertino
A
Damasceno
Momentum Research, Durham, North Carolina, United States.
Christopher
C
Edwards
Department of Medicine, University College Hospital, Ibadan, Nigeria.
Okechukwu S
OS
Ogah
Uganda Heart Institute, Kampala, Uganda.
Charles
C
Mondo
Department of Internal Medicine, Douala General Hospital and Buea Faculty of Health Sciences, Douala, Cameroon.
Anastase
A
Dzudie
Department of Medicine, University of Abuja Teaching Hospital, Abuja, Nigeria.
Dike B
DB
Ojji
Department of Internal Medicine, Douala General Hospital and Buea Faculty of Health Sciences, Douala, Cameroon.
Charles
C
Kouam Kouam
Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
Ahmed
A
Suliman
Department of Medicine, Aga Khan University, Nairobi, Kenya.
Gerald
G
Yonga
Service de Cardiologie, Faculté de Médecine de Dakar, Dakar, Senegal.
Sergine
S
Abdou Ba
Addis Cardiac Hospital, Addis Ababa, Ethiopia.
Fikru
F
Maru
Addis Cardiac Hospital, Addis Ababa, Ethiopia.
Bekele
B
Alemayehu
Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
Karen
K
Sliwa
D000208:Acute Disease; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000639:trends*; D010351:Patient Discharge / Q000639:trends*; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome
Africa; Symptoms; acute heart failure; outcome; signs