ArticleInternational journal of emergency medicine2025
Outcomes and drug-related admissions of cardiovascular patients in the emergency department at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Article in International journal of emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionCardiovascular 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.
objectiveThis 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.
methodsThis 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.
resultsAmong 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.
conclusionThe 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.
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