HYPERTENSION AS A PREDICTOR IN-HOSPITAL MORTALITY AMONG PATIENTS HAVING CONGESTIVE HEART FAILURE

Background; Hypertension remains an important risk factor which contributes towards the worsening of the outcomes, consisting of cardio-renal anemia syndrome and its impact in heart failure remains to be complex and multifactorial. The current study was done to evaluate the role of hypertension on mortality among patients having congestive heart failure. Material and methods; This study included a total of 115 patients with congestive heart failure presenting at Nishtar Hospital Multan. These patients were followed till discharge to document in-hospital mortality during current hospitalization. All the sociodemographic distribution and other relevant information such as age, gender, area of residence, diabetes, hypertension,  obesity, smoking, hyperlipidemia and mortality were noted in the proforma and data was entered and analyzed by SPSS version 22 for descriptive statistics and tests of significance. hypertension was cross-tabulated against in-hospital mortality using two by two table and chi-square test was applied at level of significance of 0.05. Results; Among our 115 patients with congestive heart failure, 75 (65.2%) were males and 40 (34.8%) were females. Mean age of our patients with CHF was 57.17 ± 11.65 years ranging from 34 to 80 years. Although males were younger than female patients with congestive heart failure but this difference was not statistically significant (p=0.140). Seventy five (65.2%) were from rural areas, 40 (34.8%) were poor, 70 (60.9%) from middle income families and only 5 (4.3%) belonged to rich families. Mean body mass index (BMI) of patients with congestive heart failure was 26.12 ± 2.93 kg/m2 and 35 (30.4%) were obese. Twenty five (21.7%) were smokers. Forty five (39.1%) had diabetes and 55 (47.8%) had hypertension. In-hospital mortality in patients with congestive heart failure was 12 (10.4%) and of these 12 mortalities, hypertension was noted in 11 (92 %) patients. Conclusion; Our study results have documented high frequency of hypertension among patients with congestive heart failure and hypertension was significantly associated with in – hospital mortality. Keywords; Congestive Heart Failure, hypertension, in-hospital mortality. DOI: 10.7176/JMPB/55-07 Publication date:May 31st 201

ATRIAL FIBRILLATION AS A PREDICTOR OF IN-HOSPITAL MORTALITY IN PATIENTS WITH ISCHEMIC STROKE.

Objective; To determine the frequency of in – hospital mortality in atrial fibrillation patients having ischemic stroke at a tertiary care hospital. Study design; Cross-sectional study. Setting; Department of Medicine, Nishtar Hospital, Multan. Material and methods; All the cases of ischemic stroke having atrial fibrillation (171), fulfilling inclusion criteria was recruited from indoor and outdoor of Department of General Medicine, Nishtar Hospital Multan from May 2018 to May 2019. These patients were investigated for the presence of atrial fibrillation, diabetes, hypertension, smoking and obesity and data was analyzed by SPSS version 18. Results; A total of 171 patients with ischemic stroke having atrial fibrillation were taken. Of these 171 patients, 112 (65.5%) were male patients while 59 (34.5%) were female patients. Mean age of our patients was 58.32 ± 12.06 years, ranging from 41 to 81 years while 54 (31.6%) were aged up to 50 years and 119 (69.6%) were aged more than 50 years. Of these 171 patients, 52 (30.4%) were from rural and 119 (69.6%) from urban areas, 87 (50.9%) belonged to poor families and 84 (49.1%) belonged to middle income families. Sixty-six (38.6%) were diabetic and 106 (62%) were hypertensive. Mean body mass index was 25.39 ± 3.81 kg/m2 with obesity was present in 46 (26.9%) while 66 (38.6%) were smokers and all smokers were male patients. Mortality was noted in 72 (42.1%) in ischemic stroke patients having atrial fibrillation. Conclusion; Frequency of mortality was high in our study among patients with ischemic stroke having atrial fibrillation. Mortality was significantly associated with male gender, smoking. diabetes, hypertension and obesity. Keywords; Ischemic stroke, atrial fibrillation, risk factors. DOI: 10.7176/JMPB/55-06 Publication date:May 31st 201