Abstract:
Background: Sustained arrhythmias are frequently encountered in cardiac care units
(CCU), but their types and outcomes in Africa are unknown. Studies from high-income
countries suggest arrhythmias are associated with worse outcomes.
Objectives: To determine the types and proportion of cardiac arrhythmias among
patients admitted to the CCU at Moi Teaching and Referral Hospital (MTRH), and to
compare 30-day outcomes between patients with and without arrhythmias at the
time of CCU admission.
Methods: We conducted a prospective study of a cohort of all patients admitted to
MTRH-CCU between March and December 2021. They were stratified on the presence
or absence of arrhythmia at the time of CCU admission, irrespective of whether it was
the primary indication for CCU care or not. Clinical characteristics were collected using
a structured questionnaire. Participants were followed up for 30 days. The primary
outcome of interest was 30-day all-cause mortality. Secondary outcomes were 30-
day all-cause readmission and length of hospital stay. The 30-day outcomes were
compared between the patients with and without arrhythmia, with a p value < 0.05
being considered statistically significant.
Results: We enrolled 160 participants. The median age was 46 years (IQR 31, 68), and
95 (59.4%) were female. Seventy (43.8%) had a diagnosis of arrhythmia at admission,
of whom 62 (88.6%) had supraventricular tachyarrhythmias, five (7.1%) had ventricular
tachyarrhythmias, and three (4.3%) had bradyarrhythmia. Atrial fibrillation was the
most common supraventricular tachyarrhythmia (82.3%). There was no statistically
significant difference in the primary outcome of 30-day mortality between those who
had arrhythmia at admission versus those without: 32.9% versus 30.0%, respectively
(p = 0.64). Conclusion: Supraventricular tachyarrhythmias were common in critically hospitalized
cardiac patients in Western Kenya, with atrial fibrillation being the most common.
Thirty-day all-cause mortality did not differ significantly between the group admitted
with a diagnosis of arrhythmia and those without.
