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Long-Term Outcomes and Factors Associated With Mortality Among Patients With Moderate to Severe Pulmonary Hypertension in Kenya

Thesis Info

Author

Abdulaziz Mansur Abeid

Department

Internal Medicine (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2018

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728055032

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Background: Pulmonary hypertension (PH) is a condition that carries significant morbidity and mortality. Studies done in sub-Saharan Africa have reported poor short-term outcomes. However, data on long-term outcomes and prognostic factors are lacking. Objectives: This study sought to determine the one and two-year survival rates and prognostic factors associated with mortality in patients with moderate to severe PH. Methods: A retrospective review of moderate to severe PH patients [pulmonary artery systolic pressure (PASP), ≥45 mmHg] diagnosed at Aga Khan University Hospital, Nairobi from 2014 to 2017 was carried out. Demographic, clinical and in hospital outcome data were extracted from medical charts; and telephone interviews were conducted to determine out of hospital outcomes. Kaplan-Meier method was used for survival analysis and log rank tests were done to assess for differences between subgroups. Cox regression modelling with multivariable adjustment were used to identify factors associated with all-cause mortality. Results: A total of 659 patients were enrolled in this study, of which 50 (7.6 per cent) were lost to follow-up. The median PASP was 56 mmHg (interquartile range, 49–68 mmHg). After a median follow-up of 626 days, the one and two-year overall survival rates were 73.8 and 65.9 per cent, respectively. Using multivariate cox regression analyses, mortality was significantly associated with age, diabetes mellitus, atrial fibrillation, WHO functional class III and IV, severe pulmonary artery systolic pressures, right ventricular and left v ventricular systolic dysfunction. However, gender, systemic arterial hypertension, rheumatic heart disease and presence of significant valvular abnormalities had no significant association with mortality. Conclusion: Pulmonary hypertension is associated with poor long-term outcomes in African patients with overall survival rate of 65.9 per cent at two years. Identification of poor prognostic factors can assist in identifying high-risk patients.
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بھٹو کا خوف

بھٹو کا خوف

اسٹیبلشمنٹ پر آج بھی بھٹو صاحب کا خوف طاری ہے ۔بھٹو اپنے انتخابی نشان تلوار کی طرح مخالفین کے اعصاب پر چھا یا ہوا ہے ۔مخالف بھٹو کی سوچ سے اس لیے بھی ڈرتے ہیں کہ یہ سوچ آج بھی زندہ ہے ۔لاکھوں لوگ بھٹو شہید کے مزار پر آتے  ہیں اور ایک نئی طاقت لے کر واپس جاتے یہں ۔

 

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