The spectrum, prevalence and in-hospital outcomes of cardiovascular diseases in a South African district hospital: a retrospective study

Cardiovasc J Afr. 2021;32(5):237-242. doi: 10.5830/CVJA-2021-016. Epub 2021 Jun 10.

Abstract

Introduction: The increasing prevalence of cardiovascular risk factors in South African rural communities is well reported. However, the prevalence of cardiovascular disease (CVD) leading to hospital admission and related in-hospital mortality in rural and semi-rural hospitals is unknown.

Methods: We conducted a retrospective review of hospital records for patients admitted to the Department of Internal Medicine at Dora Nginza Hospital in Port Elisabeth, South Africa between 1 April and 31 October 2016. The study focused on patients who received a primary diagnosis of CVD.

Results: During the seven-month study period, 4 884 patients were admitted to the unit, 1 325 of whom received a primary diagnosis of CVD, giving a prevalence of 27%. Patients with CVD had a mean (standard deviation) age of 60 (± 15) years, 32% of this patient population was younger than 55 years and 65% were female. Furthermore, 94% had a background medical history of systemic hypertension and 30% of diabetes mellitus. The three leading cardiovascular causes of hospital admission were stroke (38%), hypertensive heart disease plus heart failure (33%), and hypertensive emergency/urgency (18%). In-hospital outcome: 12.4% of patients admitted for CVD died during the index hospitalisation and strokes were responsible for 70% of the deaths.

Conclusions: The prevalence of CVD in this cohort was high and accounted for significant morbidity and mortality. Systemic hypertension was a leading risk factor in our cohort and we need to intensify efforts to diagnose and treat systemic hypertension.

Keywords: low‐income country; cardiovascular disease; in‐hospital outcomes.

MeSH terms

  • Aged
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / mortality*
  • Cardiovascular Diseases / therapy
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / epidemiology*
  • Hospital Mortality
  • Hospitalization / statistics & numerical data*
  • Hospitals, District
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Socioeconomic Factors
  • South Africa / epidemiology
  • Stroke / complications
  • Stroke / epidemiology