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2025 ; 18
(1
): 218
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Outcomes and drug-related admissions of cardiovascular patients in the emergency
department at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
#MMPMID41131477
Husein H
; Tadesse TA
; Belayneh A
; Kefyalew M
; Tsegaye MA
; Endegnanew EG
; Elssa MW
; Sisay EA
Int J Emerg Med
2025[Oct]; 18
(1
): 218
PMID41131477
show ga
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.