Trends in Clinical Profile, Hospital Mortality and Its Predictive Factors,

of Acute Heart Failure Cases in RSUD Kota Madiun

E. Sandjojo1, E.F. Rifani1, V.A.M.C. Jaury2, Y.K. Astari3, M. Sukmana4

General practitioner, RSUD Kota Madiun, Madiun, Indonesia
1

2
Faculty of Medicine, Airlangga University, Surabaya, Indonesia
3
Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
4
Cardiologist, RSUD Kota Madiun, Madiun, Indonesia

Background: There is a gap in the knowledge of heart failure status in Indonesia. This study
aimed to examine the clinical profile of acute heart failure patients in RSUD Kota Madiun
and the factors related to mortality, particularly in 2020.
Methods: 213 patients with acute heart failure (AHF) admitted from January to June 2020 at
RSUD Kota Madiun, Indonesia, were enrolled. The data were collected using Swedish Heart
Failure registry. We also compared it with the previous data on 2017-2018.
Results: From 213 patients with symptoms of AHF, over half (53.1%) were male. The
median age was 63 years. The most common etiology of AHF were hypertension accounting
for 52.6% of cases. The most prevalent sign observed was rales (97.4%), followed by
peripheral oedema (11.7%). About 83.6% patients had at least one comorbidity. Most of the
patients (97.7%) were prescribed diuretics, 42.7% angiotensin-converting enzyme inhibitors
(ACE-I), 28.2% angiotensin receptor blockers, 68.5% beta-blockers, and 70.9%
mineralocorticoid receptor blockers. The median length of stay (LOS) was four days and the
hospital mortality rate was 9.4%. Compared with the data in 2017-2018, we observed a
higher frequency of the patients receiving ACE-I (42.7% versus 18%, p<0.001), shorter LOS
(4 versus 6.26 days, p<0.001), and lower mortality (9.4% versus 17%, p=0.052). From the
multivariate analysis, a higher potassium serum on admission and cerebrovascular accident
comorbidity were the significant predictors of hospital mortality (OR=1.49; CI 95% 1.08–
2.05 and OR=7.37; CI95% 1.56–34.66).
Conclusion: Hypertension remains the leading cause of heart failure in RSUD Kota Madiun.
In 2020, we observed a higher frequency of the patients receiving ACE-I, shorter LOS, and
lower hospital mortality of AHF and also a high potassium serum and cerebrovascular
accident comorbidity as significant predictors of hospital mortality.
Keywords: acute heart failure; clinical characteristics; management; mortality