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Introduction <p>Cardiovascular diseases (CVDs) are the leading cause of death globally, with a rising prevalence. The increase in medications, recognized conditions, and polypharmacy has led to more drug-related problems and emergency admissions among patients with CVD, negatively affecting healthcare outcomes and increasing morbidity and mortality.</p> Objective <p>This study aimed to assess outcomes of patients with CVD in the Emergency Department (ED) of Tikur Anbessa Specialized Hospital (TASH), the frequency of drug-related admissions, and factors associated with admissions and outcomes.</p> Methods <p>This prospective observational study included all patients with cardiovascular disease who presented to the Adult ED of TASH between September and December 2022, provided informed consent, and were taking at least one medication for their cardiovascular condition. Admission outcomes and prevalence of drug-related emergency admissions were calculated as percentages. Kaplan-Meier survival, Cox regression, and logistic regression analyses were used to estimate ED survival, factors associated with survival, and factors related to drug-related emergency admissions, respectively.</p> Results <p>Among 401 patients with CVD admitted to the ED, 23% had drug-related emergency admissions (DREAs), with non-adherence accounting for 58.4% of these cases. The overall ED mortality rate was 9.5%, with acute decompensated heart failure (ADHF) being the leading cause of death. Smoking history, dilated cardiomyopathy, gastrointestinal comorbidities, atrial fibrillation, and polypharmacy were significant predictors of early mortality. The most common ED admission diagnoses were congestive heart failure/ADHF (37.4%) and hypertension (26.2%), and diuretics, especially furosemide, were the most frequently prescribed medications. Additionally, polypharmacy, smoking, younger age (&lt; 18 years), longer disease duration, and marital status were significantly associated with a higher risk of DREAs.</p> Conclusion <p>The mortality rate among patients with CVD admitted to TASH’s ED of TASH was 9.5%. DREAs were observed in 23% of patients. Survival did not differ significantly according to the DRP status. There was no significant difference in survival between patients admitted with and without DRPs. Early death was linked to smoking, gastrointestinal comorbidity, dilated cardiomyopathy, atrial fibrillation, and polypharmacy.</p>

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Outcomes and drug-related admissions of cardiovascular patients in the emergency department at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月23日

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  • Hikma Husein,
  • Tamrat Assefa Tadesse,
  • Alemu Belayneh,
  • Merahi Kefyalew,
  • Mesfin Ayalew Tsegaye,
  • Elias Gashaw Endegnanew,
  • Matyas Wondwossen Elssa,
  • Eskinder Ayalew Sisay

摘要

Introduction

Cardiovascular diseases (CVDs) are the leading cause of death globally, with a rising prevalence. The increase in medications, recognized conditions, and polypharmacy has led to more drug-related problems and emergency admissions among patients with CVD, negatively affecting healthcare outcomes and increasing morbidity and mortality.

Objective

This study aimed to assess outcomes of patients with CVD in the Emergency Department (ED) of Tikur Anbessa Specialized Hospital (TASH), the frequency of drug-related admissions, and factors associated with admissions and outcomes.

Methods

This prospective observational study included all patients with cardiovascular disease who presented to the Adult ED of TASH between September and December 2022, provided informed consent, and were taking at least one medication for their cardiovascular condition. Admission outcomes and prevalence of drug-related emergency admissions were calculated as percentages. Kaplan-Meier survival, Cox regression, and logistic regression analyses were used to estimate ED survival, factors associated with survival, and factors related to drug-related emergency admissions, respectively.

Results

Among 401 patients with CVD admitted to the ED, 23% had drug-related emergency admissions (DREAs), with non-adherence accounting for 58.4% of these cases. The overall ED mortality rate was 9.5%, with acute decompensated heart failure (ADHF) being the leading cause of death. Smoking history, dilated cardiomyopathy, gastrointestinal comorbidities, atrial fibrillation, and polypharmacy were significant predictors of early mortality. The most common ED admission diagnoses were congestive heart failure/ADHF (37.4%) and hypertension (26.2%), and diuretics, especially furosemide, were the most frequently prescribed medications. Additionally, polypharmacy, smoking, younger age (< 18 years), longer disease duration, and marital status were significantly associated with a higher risk of DREAs.

Conclusion

The mortality rate among patients with CVD admitted to TASH’s ED of TASH was 9.5%. DREAs were observed in 23% of patients. Survival did not differ significantly according to the DRP status. There was no significant difference in survival between patients admitted with and without DRPs. Early death was linked to smoking, gastrointestinal comorbidity, dilated cardiomyopathy, atrial fibrillation, and polypharmacy.