Short-term Outcomes and Prognostic Determinants in Hospitalized HFrEF Patients: A Single-Center North African Cohort Study with International Benchmarking
Mariam Ouaziz *
Department of Cardiology, Faculty of Medicine and Pharmacy, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco.
Imane Chadbellah
Department of Cardiology, Faculty of Medicine and Pharmacy, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco.
Ranim Khzami
Department of Cardiology, Faculty of Medicine and Pharmacy, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco.
Asmaa EL Fathi
Department of Cardiology, Faculty of Medicine and Pharmacy, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco.
Abdelmajid Bouzerda
Department of Cardiology, Faculty of Medicine and Pharmacy, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco.
Ali Khatouri
Department of Cardiology, Faculty of Medicine and Pharmacy, Avicenne Military Hospital, Cadi Ayyad University, Marrakech, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Short-term outcomes in HFrEF, including in-hospital mortality and 30-day rehospitalization, reflect the quality of acute care and the adequacy of discharge management. Data from North African settings remain scarce.
Aim: The study aims to evaluate in-hospital outcomes and 30-day post-discharge status among patients hospitalized with HFrEF at a tertiary care center in Morocco, and to identify clinical predictors of short-term adverse outcomes while benchmarking findings against international registries.
Methods: A retrospective cohort study was conducted among 173 HFrEF patients admitted to the Avicenne Military Hospital of Marrakech between December 2021 and December 2023. In-hospital mortality, causes of death, 30-day follow-up adherence, and rehospitalization rates were assessed and benchmarked against international registries.
Results: In-hospital stabilization was achieved in 94.7% of patients. In-hospital mortality was 5.3% (9 deaths): 4 due to sustained ventricular tachycardia and 5 due to refractory cardiogenic shock. At 1 month, 76.3% maintained regular follow-up, 12.7% were lost to follow-up, and 5.7% were rehospitalized for decompensation. Predictors of adverse outcomes included severe LV dysfunction, right ventricular failure, and renal impairment.
Conclusion: Mortality rates are comparable to international registries, but the high lost-to-follow-up rate and low rehospitalization tracking underscore the need for structured post-discharge HFrEF management programs in Morocco.
Keywords: HFrEF, in-hospital mortality, rehospitalization, cardiogenic shock, ventricular arrhythmia, outcomes, North Africa, Morocco