Introduction: Liver abscess is a serious condition due to its complications. The most frequent complication is rupture. Our aim is to determine the predictive risk factors of liver abscess rupture at the Saint Louis Regional Hospital Center. Material and methods: This is a prospective descriptive and analytical study over the period of 1 st January 2016 to 28 th February 2019. We included liver abscess records regardless of age. An univariate and then multivariate analysis according to a Cox model allowed us to determine the factors associated with the occurrence of rupture. Results: We collected 138 cases with 78 cases of amoebic abscess (55.3%) and 60 cases of pyogenic abscess (42.6%). We had 36 cases of rupture (26%), including 29 cases in the peritoneal cavity. The mean age was 28 years ± 18. The sex ratio (M:F) was 3.7. There were 35.5% (n= 49) of patients aged under 15 years. The mean consultation time was 18.8 days ± 4.5. The localization was the right lobe in 76.7%, the left lobe in 9.3% and bi lobar in 14%. The mean diameter of abscesses was 8 cm ± 7.5 (Range: 3.7; 16 cm). The abscesses were unique in 85.5% of cases, and sub-capsular in 15.2% of case. Gas was present in 5.7% of cases. The commonest germ found was Staphylococcus aureus in 14.5% of patients. The predictive risk factors of rupture found after univariate analysis were: diameter (p <0.001), age less than 15 years (OR= 4.3; p<0.001), pyogenic origin of abscesses (OR= 4.3, p <0.001), undernutrition (OR=2.3, p= 0.038), jaundice (OR = 4.5, p = 0.009) , left-lobe localization (OR= 7, p = 0.002), subcapsular localization (OR=8.6, p <0.001); the presence of gas (p <0.001). Multivariate analysis identifi ed 5 variables considered as independent risk factors for rupture: the pyogenic origin (HR= 22.51, p<0.001); age less than 15 years (HR= 2,296, p= 0.049); abscess diameter (HR= 1.411, p= 0.004); left lobe localization (HR= 18.68, p <0.001) and sub-capsular localization (HR= 2.689, p= 0.017). Conclusion: In our study, predictive risk factor for liver abscess rupture were: pyogenic origin, age less than 15 years, abscess diameter, left-lobe and subcapsular localization. The knowledge of these factors allows early and appropriate treatment to avoid complications.
Introduction: Diabetes prevalence has increased over the past years. In Senegal, this prevalence is 4% in the general population. However, the region of Saint-Louis (in the north of the country) has the highest rate with 10.4%. The main prognosis problem is the occurrence foot lesions that can lead to lower-limbs amputation. Diabetic foot is a real public health issue, due to its economic burden and its serious repercussions on patients, leading to poor quality of life. The objective of this case-control study is to identify factors associated with foot lesions in diabetic patients. Methods and analysis:It will be a case-control study from January to December 2021. The patients will be recruited from the departments of general surgery, internal medicine, and emergency. An univariate then multivariate analysis (logistic regression) will allow us to select the variables associated with foot lesions in our study population. The parameters included in the logistic regression will be those with a p < 0.20 in the univariate analysis. Finally, a binary logistic regression analysis (with the calculation of Odds Ratios (OR) with confidence intervals (CI)) according to the backward stepwise method will identify the factors independently associated to foot lesions in diabetic patients. Ethics and dissemination:This research protocol will be submitted to the Ethics Committee of our institution for approval. The knowledge of factors causing diabetic foot will help to communicate with policymakers to raise the awareness in our community. Finally, it will help to prevent lower limb amputations. Highlights• Diabetes is the leading cause of non-traumatic lower-limb amputation in the world.• The region of Saint-Louis (Senegal) has the highest prevalence of diabetes.• Controlling factors associated with foot lesions in diabetic patients can prevent from amputation.
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