Abstract:
Acute heart failure is the gradual or rapid change of heart failure signs and 
symptoms, which poses a unique diagnostic and management challenge, requiring urgent 
therapy. It is responsible for nearly one million hospitalizations each year globally with rising 
rates. Despite therapeutic advances, it is associated with poor prognosis.
Objective: To assess in-hospital mortality and its associated factors among adult acute heart 
failure patients at Haramaya University Hiwot Fana Comprehensive Specialized Hospital, Harar, 
Ethiopia, from July 15 to August 14, 2021.
Methods: A hospital based retrospective cross-sectional study was employed among 454 adult 
acute heart failure patients treated in the medical ward of Haramaya University Hiwot Fana 
Comprehensive Specialized Hospital from June 01, 2016 to May 31, 2021. Data was collected 
using structured data abstraction format from July 15 to August 14, 2021. Collected data was 
entered to EpiData version 3.1, exported to, and analyzed using statistical package for social 
science (SPSS) version 21.0. Bivariate and multivariate logistic regression was used to identify 
factors associated with in-hospital mortality.
Results: A total of 454 acute heart failure patient‟s medical records were reviewed. More than 
half, 282(62.1%) of patients were females. The median age of patients was 45 years (±28 IQR). 
In-hospital mortality was 18.9% and it was more prevalent in the first week of admission, 
61(70.9%). Sex (female) (adjusted odds ratio (AOR) = 2.83, p = 0.001)), having smoking history 
(AOR = 2.51, p = 0.031), generalized body swelling (AOR = 2.67, p = 0.001), hypotension (AOR 
= 4.56, p = 0.001), and tachycardia (AOR = 4.57, p = 0.000) were factors associated with in hospital mortality.
Conclusion and recommendation: in-hospital mortality is found to be very high therefore 
dedicated programs need to be developed to reduce mortality from acute heart failure and further 
prospective research should be conducted to investigate the problem in-depth.