Morbidity Patterns, Outcomes and Associated Factors Among Patients Admitted In Coronary Care Unit at Jakaya Kikwete Cardiac Institute, Dar Es Salaam, Tanzania

Abstract

Background Coronary care unit is a specialized unit for caring of critically ill cardiac patients. With the increasing burden of disease it is no doubt this special unit is crucial, however the causes of admission, outcomes and associated factors are not known in our settings. Objective of this study To evaluate the causes of admission, mortality rate and disease factors associated with the outcome among patients admitted in coronary care unit at Jakaya Kikwete Cardiac Institute (JKCI). Methodology Hospital based cross-sectional study conducted at JKCI. All patients admitted at the Coronary care unit meeting the inclusion criteria were enrolled after consenting. Mayo Cardiac Intensive Care Unit Admission Risk Score (M-CARS) was used as an illness severity score tool to predict the mortality upon admission at the unit. Data was analyzed using SPSS version 23. Results 115 patients were studied. Acute heart failure was the major indication for admission among patients admitted due to acute illness, with a mortality rate of 31.2%. Admission diagnosis of cardiogenic shock (p-value=0.01), respiratory failure (p-value=0.03), M-CAR score (p value=0.00), development of sepsis (p-value=0.013), AKI (p-value=0.02), Cerebrovascular accidents (p-value=0.09) during CCU stay were associated with mortality. Conclusion and Recommendation Majority of critically ill patients admitted at JKCI CCU have acute heart failure with mortality rate of 31.2%. Patients admitted with diagnosis of; cardiogenic shock, respiratory failure, those with higher M-CARS and those who developed sepsis, AKI, Cerebrovascular accidents duringCCU stay were more likely to die in CCUA higher mortality rate seen compared to other regions of the world, calls for further studies to determine the cause and hence improve cardiac care in our setting. The association between high MCAR Score on admission and mortality among patients admitted at JKCI CCU shown could be a hallmark for the use of this novel tool in our setting if further larger studies are done to vaalidate its use.