Gender differences among patients hospitalized with acute heart failure in a tertiary care teaching hospital: A cross-sectional study

Abstract

Background: Heart failure (HF) prevalence in India is about 1% which is about 8–10 million, and significant gender differences exist. Aims: This study was done to investigate the differences in modes of presentation, cardiac etiology, comorbidities, and inhospital outcomes between both genders and to identify predictors of prolonged hospital stay. Settings and Design: We conducted a cross-sectional descriptive study from November 2016 in the coronary care unit. Materials and Methods: Consenting adult patients admitted with the primary diagnosis of acute HF were included. Patients with reversible noncardiac circulatory failure and malignancies were excluded. Their clinical details and inhospital outcomes were recorded. Results: Out of 150 patients, 86 (57.33%) were males and 64 (42.6%) females. More women were admitted with Stage 4 New York Heart Association (59 [92.2%], P = 0.002), cardiogenic shock (10 [15.6%], P = 0.04), or with hypertensive emergency (23 [35.9%], P = 0.027). The mean duration of stay in males was 6.17 ± 2.21 days and 7.23 ± 2.69 days in females (P = 0.009). Multivariate analysis showed that the adjusted risk of prolonged hospital stay (≥7 days) was 4.6 (95% confidence interval: 1.96, 10.82), with the risk being almost five times greater among patients with the presence of cardiorenal syndrome (CRS), compared to those who did not have it (P < 0.001). Statistical Analysis: Chi-square, Student's t-test, and logistic regression were used in the study. Conclusion: Our study highlighted that women were more vulnerable, and came in with advanced HF or hypertensive emergency and stayed in the hospital for a longer duration. CRS was the crucial predictor of prolonged hospital stay.

Keywords

• acute heart failure
• cardiorenal syndrome
• gender inequities