摘要
Background:Heart failure(HF)mortality is a critical challenge in low-re-source settings like Cameroon,where predictors and trends are poorly under-stood.This study evaluated in-hospital mortality rates,trends,and predictors among HF patients at a Cameroonian tertiary cardiology unit.Methods:This retrospective cohort study analysed 757 HF admissions at Laquintinie Hospi-tal,Douala(2021-2024).Multivariable logistic regression identified mortality predictors(p<0.05),with model fit assessed via the Hosmer-Lemeshow test and area under the receiver operating characteristic curve(AUC).Results:Among 757 HF patients(median age 63 years,51.3%female),hypertensive heart disease(28.5%)was prevalent,with an in-hospital mortality rate of 17.0%(n=129).Multivariable analysis identified elevated Blood Urea Nitro-gen(BUN)(aOR=1.01,95%CI:1.01-1.02,p<0.001),dobutamine use(aOR=2.85,95%CI:1.30-6.25,p=0.009),and admission in 2023-2024(aOR=1.79,95%CI:1.15-2.80,p=0.010)as mortality predictors,while hypertensive heart disease(OR=0.40,95%CI:0.21-0.77,p=0.006)and higher systolic blood pressure(aOR=0.99,95%CI:0.98-1.00,p=0.009)were protective.Calcium channel blockers(p=0.102),RAAS inhibitors(p=0.100),and betablockers(p=0.129)were not significant.Model fit was robust(Hosmer-Leme show p=0.811,AUC=0.769).Conclusions:In-hospital HF mortality was high, driven by elevated BUN, dobutamine use, and later admission years, potentially reflecting increased patient acuity or resource constraints. Hypertensive heart disease and higher systolic blood pressure were protective. Interventions to enhance diagnostic access (e.g., echocardiography, ECG), and address systemic healthcare barriers are critical. Prospective studies are needed to investigate rising mortality trends and optimize HF management in Cameroon.
