Aetiology and outcome of childhood heart failure in an emergency paediatric unit in North Central Nigeria

Background: Heart failure is a common consequence of both cardiac and non-cardiac disease contributing significantly to mortality amongst children. Objective: The study aims to describe the burden of heart failure in an emergency paediatric unit (EPU), its causes and the outcome. Methods: This is a retrospective review of admissions into the EPU over a 24-month period from May 2013 to April 2015. Children aged 1 month to 14 years who met the case definition for heart failure were recruited. Unit registers and hospital folders were reviewed, and data on age, sex, aetiology of heart failure, and outcome were extracted and recorded. Results: Two hundred and ninety-one (12.5%, 95% confidence interval: 11.3-14.0) of the 2321 medical admissions over the study period had heart failure. Majority (75.6%) of the children were aged < 5 years and 164 (56.4%) were male. The common causes of heart failure were severe anaemia (66.7%), acute lower respiratory infections (21.3%), congenital disease (8.3%) and acquired heart disease (3.8%). The case fatality rate for heart failure was 5.8% (17 deaths) with majority (64.7%) of the deaths resulting from severe anaemia. Conclusion: Heart failure is a common contributor to morbidity and mortality in this environment, and the causes are largely preventable. Aggressive management of these cases may result in an improved outcome.