Zahidullah Khan, Noor Muhammad, Zahid Fida, Wazir Muhammad, Inam Ullah Khan, Aliena Badshah.
Factors precipitating chronic heart failure - study in tertiary care hospital.
J Med Sci Jan ;27(3):220-4.

Objectives: To identify the factors precipitating heart failure(HF) in patient admitted in a tertiary care hospital.Material and Methods: This study cross sectional, retrospective, observational single center study was carried out in the department of medicine Khyber Teaching Hospital Peshawar - Pakistan from April 2017 to March 2018. The total sample size was 151, keeping 8% margin of error and 95% confidence interval. All the patients were either diagnosed as CCF in ward / OPD or previously diagnosed and came to ward with other complaints. All admitted patients or patients seen in OPD were included in study. Results: A total of 151 already diagnosed congestive cardiac failure patients were enrolled in the study. Out of 151 patients, 86 were male and 65 were female. The age distribution amongst study group was 25 to 65 years. The mean age of the patients was 51.5+/-12.5 SD years. Minimum age of the patients was 17 years and maximum age was 75 years. The major factors causing exacerbation of previously stable heart failure were poor drug compliance (34%),Infection (34%), uncontrolled hypertension (33%), uncontrolled diabetes mellitus (32%), new onset arrhythmia (29%),new onset ischemia (26%), anemia (23%), deranged renal function tests (13%),Hyperthyroidism (09%), fluid retaining drugs (06%) and hypothyroidism (03%). Conclusion: Poor drug compliance, infection and uncontrolled hypertension/diabetes mellitus are the commonest causes leading to heart failure. Proper patient education, unnecessary medications and timely follow up can reduce the rate of hospital admission and possible mortality

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