Short-term Outcomes and Prognostic Determinants in Hospitalized HFrEF Patients: A Single-Center North African Cohort Study with International Benchmarking

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.