[Early readmission and mortality in heart failure patients at a tertiary care hospital in West Africa (Ouagadougou): Predictors from a two-year retrospective study].
Thiombiano L, Thiam A, et al. • Annales de cardiologie et d'angeiologie • 2026
Heart failure remains highly prevalent and severe in low-resource settings, with early rehospitalization strongly associated with excess mortality, and independent predictors of 30-day readmission including male sex, chronic kidney disease, hypertensive heart disease, and beta-blocker use.
Key Findings
Results
The hospital prevalence of heart failure was 34.28% among all admissions at the tertiary care hospital in Ouagadougou.
396 out of 1155 total admissions were heart failure cases over the two-year study period (January 1, 2022 to December 31, 2023).
The study was conducted at Bogodogo University Hospital in Ouagadougou, Burkina Faso.
All consecutive patients admitted for acute or decompensated chronic HF were included.
The study design was retrospective, descriptive, and analytical cohort.
Results
At discharge, over one-third of heart failure patients still exhibited clinical signs of heart failure.
37.63% (149/396) of patients still had clinical signs of HF at the time of discharge.
This suggests incomplete clinical resolution prior to hospital discharge in a substantial proportion of patients.
This finding may relate to resource constraints in a low-resource tertiary care setting.
Results
The overall in-hospital mortality rate over the two-year study period was 17.42%.
69 out of 396 hospitalized heart failure patients died in-hospital during the study period.
Mortality among readmitted patients was substantially higher at 36.66% (11/30).
Early rehospitalization was strongly associated with excess mortality.
Results
The 30-day readmission rate was 7.57%, with the majority of readmissions occurring within the first two weeks after discharge.
30 out of 396 patients were readmitted within 30 days of discharge.
69.77% of readmissions occurred within the first two weeks after discharge.
The mean length of hospital stay increased from 7 days during the index hospitalization to 11 days at readmission.
Authors note the 30-day readmission rate was 'relatively low' compared to other settings.
Results
Male sex, chronic kidney disease, hypertensive heart disease, and beta-blocker use were independent predictors of 30-day early readmission.
Male sex was a significant predictor of early readmission (P=0.043).
Chronic kidney disease was an independent predictor of early readmission (P=0.013).
Hypertensive heart disease was an independent predictor of early readmission (P=0.035).
Beta-blocker use was an independent predictor of early readmission (P=0.033).
Predictors were identified using univariate and multivariate logistic regression analyses.
Results
Intercurrent infections (mainly pneumonia), presence of a mitral regurgitation murmur, and ventricular arrhythmias were independent factors associated with in-hospital mortality.
Intercurrent infections were significantly associated with mortality (P=0.016).
Pneumonia specifically was an independent predictor of mortality (P=0.036).
Presence of a mitral regurgitation murmur was independently associated with mortality (P=0.020).
Ventricular arrhythmias were independently associated with mortality (P=0.023).
Predictors were identified through multivariate logistic regression analysis.
What This Means
This research examined what happens to heart failure patients admitted to a major hospital in Ouagadougou, Burkina Faso over two years. The study found that heart failure was extremely common, accounting for about one in three hospital admissions, and that more than a third of patients were still showing signs of heart failure when they were sent home. About 17% of patients died during their hospital stay, which highlights the severity of heart failure in this resource-limited setting.
The study found that about 7.6% of patients were readmitted to the hospital within 30 days of discharge, and most of these re-hospitalizations happened within the first two weeks. Patients who were readmitted early had much higher mortality — over 36% of readmitted patients died, compared to the overall rate of about 17%. The factors that predicted early readmission included being male, having chronic kidney disease, having heart failure caused by high blood pressure, and being on beta-blocker medications. Factors linked to dying in the hospital included developing infections (especially pneumonia), having a leaky heart valve (mitral regurgitation), and having dangerous heart rhythm problems (ventricular arrhythmias).
This research suggests that in West African settings with limited resources, heart failure places an enormous burden on hospitals and patients alike. The finding that so many patients are discharged while still symptomatic, and that early readmission dramatically raises the risk of death, points to the need for better follow-up care and more complete treatment before discharge. Targeting modifiable risk factors — such as preventing infections like pneumonia and optimizing medication regimens — could potentially improve survival outcomes for heart failure patients in similar low-resource environments.
Thiombiano L, Thiam A, Bayire I, Lengani H, Nacanabo W, Seghda T, et al.. (2026). [Early readmission and mortality in heart failure patients at a tertiary care hospital in West Africa (Ouagadougou): Predictors from a two-year retrospective study].. Annales de cardiologie et d'angeiologie. https://doi.org/10.1016/j.ancard.2026.102019