Clinical and epidemiological characterization of heart failure patients in a high-altitude setting: a retrospective study at a tertiary hospital in Quito, Ecuador.
Heart failure (HF) is a major global health problem and a leading cause of morbidity and mortality. In Latin America, evidence remains limited, and HF characterization in high-altitude care settings is underreported. Quito (-2,800 m a.s.l.) provides a unique clinical context, although retrospective hospital-based data without standardized hypoxia phenotyping or sea-level comparators cannot support altitude-specific causal inference.
This study aims to describe the clinical and epidemiological characteristics of patients diagnosed with HF at the Metropolitan Hospital of Quito, a tertiary care facility located at an altitude of approximately 2,800 meters, from January 2021 to December 2023.
A retrospective observational study was conducted using anonymized medical records of 122 patients diagnosed with HF (ICD-10 codes I500, I501, I509). Data on demographic, clinical, and outcome variables were collected. Exploratory comparisons were performed by discharge survival status (alive vs. deceased) using chi-square or Fisher's exact tests for categorical variables and two-sample Student's t-tests for continuous variables (two-sided p < 0.05).
Most patients (88.5%) were aged over 65 years, with men comprising 55.7% of the cohort. Hypertension (59.8%), dyslipidemia (18.9%), and atrial fibrillation (44.3%) were the most prevalent comorbidities. Hypertensive heart disease was the most frequent documented etiology of HF (14.8%), although etiology was unavailable in a substantial proportion of records. In-hospital mortality was low (3.3%). Exploratory univariate analyses identified unadjusted associations between in-hospital mortality and dialysis dependency, immunologic diseases, and other vascular diseases.
This study provides a contemporary clinical and epidemiological profile of HF patients managed at a high-altitude tertiary hospital in Quito and identifies exploratory factors associated with in-hospital mortality in this care setting. Future multicenter studies incorporating standardized hypoxia-related measurements and appropriate comparator cohorts are needed to better understand HF phenotypes and outcomes in Andean populations.
This study aims to describe the clinical and epidemiological characteristics of patients diagnosed with HF at the Metropolitan Hospital of Quito, a tertiary care facility located at an altitude of approximately 2,800 meters, from January 2021 to December 2023.
A retrospective observational study was conducted using anonymized medical records of 122 patients diagnosed with HF (ICD-10 codes I500, I501, I509). Data on demographic, clinical, and outcome variables were collected. Exploratory comparisons were performed by discharge survival status (alive vs. deceased) using chi-square or Fisher's exact tests for categorical variables and two-sample Student's t-tests for continuous variables (two-sided p < 0.05).
Most patients (88.5%) were aged over 65 years, with men comprising 55.7% of the cohort. Hypertension (59.8%), dyslipidemia (18.9%), and atrial fibrillation (44.3%) were the most prevalent comorbidities. Hypertensive heart disease was the most frequent documented etiology of HF (14.8%), although etiology was unavailable in a substantial proportion of records. In-hospital mortality was low (3.3%). Exploratory univariate analyses identified unadjusted associations between in-hospital mortality and dialysis dependency, immunologic diseases, and other vascular diseases.
This study provides a contemporary clinical and epidemiological profile of HF patients managed at a high-altitude tertiary hospital in Quito and identifies exploratory factors associated with in-hospital mortality in this care setting. Future multicenter studies incorporating standardized hypoxia-related measurements and appropriate comparator cohorts are needed to better understand HF phenotypes and outcomes in Andean populations.
Authors
Ullauri Ullauri, Aguirre Espinosa Aguirre Espinosa, Padilla Molina Padilla Molina, Moreira-Vera Moreira-Vera, Jaramillo Prado Jaramillo Prado, Finke Barriga Finke Barriga, Salto González Salto González, Flores Rodríguez Flores Rodríguez, Cárdenas Calderón Cárdenas Calderón, Ayala Abarca Ayala Abarca, Izquierdo-Condoy Izquierdo-Condoy, Vasconez-Gonzalez Vasconez-Gonzalez, Ortiz-Prado Ortiz-Prado
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