Hémorragie digestive haute : aspects épidémiologiques et facteurs pronostiques au Burkina Faso (Afrique de l’ouest)

Sombié, Roger; Tiendrébéogo, Arnaud Jean Florent; Guingané, Alice Nanelin; Hagège, Hervé; Lesgourgues, Bruno; Lamy, V.; Tzeuton, Christian; Bougouma, A.

doi:10.1007/s12157-015-0610-z

Cited by 7 publications

(11 citation statements)

References 17 publications

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“…In terms of outcomes, 44 studies reported mortality, 8–10,18,20–30,32–37,39,41–43,47–49,52–55,58,63–66,68–71,73–75 27 rebleeding, 8,19,20,22,25,29–31,34,35,38–40,43,45,46,50,51,55–57,60,68,70,72,…”

Section: Resultsmentioning

confidence: 99%

At admission hemodynamic instability is associated with increased mortality and rebleeding rate in acute gastrointestinal bleeding: a systematic review and meta-analysis

Tari,

Frim,

Stolcz

et al. 2023

Therap Adv Gastroenterol

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Background: Acute gastrointestinal bleeding (GIB) is a life-threatening event. Around 20–30% of patients with GIB will develop hemodynamic instability (HI). Objectives: We aimed to quantify HI as a risk factor for the development of relevant end points in acute GIB. Design: A systematic search was conducted in three medical databases in October 2021. Data sources and methods: Studies of GIB patients detailing HI as a risk factor for the investigated outcomes were selected. For the overall results, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated based on a random-effects model. Subgroups were formed based on the source of bleeding. The Quality of Prognostic Studies tool was used to assess the risk of bias. Results: A total of 62 studies were eligible, and 39 were included in the quantitative synthesis. HI was found to be a risk factor for both in-hospital (OR: 5.48; CI: 3.99–7.52) and 30-day mortality (OR: 3.99; CI: 3.08–5.17) in upper GIB (UGIB). HI was also associated with higher in-hospital (OR: 3.68; CI: 2.24–6.05) and 30-day rebleeding rates (OR: 4.12; 1.83–9.31) among patients with UGIB. The need for surgery was also more frequent in hemodynamically compromised UGIB patients (OR: 3.65; CI: 2.84–4.68). In the case of in-hospital mortality, the risk of bias was high for 1 (4%), medium for 13 (48%), and low for 13 (48%) of the 27 included studies. Conclusion: Hemodynamically compromised patients have increased odds of all relevant untoward end points in GIB. Therefore, to improve the outcomes, adequate emergency care is crucial in HI. Registration: PROSPERO registration number: CRD42021285727.

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Section: Resultsmentioning

confidence: 99%

At admission hemodynamic instability is associated with increased mortality and rebleeding rate in acute gastrointestinal bleeding: a systematic review and meta-analysis

Tari,

Frim,

Stolcz

et al. 2023

Therap Adv Gastroenterol

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“…Les péritonites aiguës généralisées par perforation gastroduodénale étaient la principale étiologie d'abdomens aigus chez nos patients. Malgré les progrès enregistrés ces dernières années dans la compréhension de la physiopathologie et la prise en charge de l'ulcère gastroduodénal [ 3 , 13 ], force est de constater que cette affection demeure un problème de santé important en Afrique [ 24 , 26 , 27 ] avec un faible accès des populations à l'endoscopie digestive haute et aux inhibiteurs de la pompe à protons. Il n'est donc pas surprenant que ses complications aiguës, telle la perforation, soient encore fréquentes.…”

Section: Discussionunclassified

Complications des prises en charge chirurgicales des abdomens aigus non traumatiques d’origine digestive à l’hôpital central de Yaoundé, Cameroun (novembre 2019 - juillet 2020)

Bang

Motto

Ngoumfe

et al. 2021

Mtsi

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Résumé Objectif Les abdomens aigus chirurgicaux non traumatiques d'origine digestive demeurent un motif fréquent d'admission aux urgences en Afrique. Nous avons entrepris ce travail dans le but d’étudier la morbi-mortalité postopératoire de ces patients au Cameroun, un pays d'Afrique centrale en voie de développement. Patients et méthodologie Il s'agissait d'une étude transversale analytique avec recueil prospectif de données, sur une période de huit mois (novembre 2019 à juillet 2020), à l'hôpital central de Yaoundé (Cameroun). Il s'agit d'une structure sanitaire publique de deuxième catégorie (intermédiaire) dans la pyramide sanitaire du Cameroun, accueillant majoritairement des patients sans assurance maladie. Ont été inclus, tous les patients opérés pour un abdomen aigu chirurgical digestif non traumatique. Le suivi des patients se faisait jusqu’à la 12 e semaine postopératoire. La régression univariée de Cox a été utilisée pour déterminer les facteurs associés à la survenue de complications postopératoires. Le seuil de significativité retenu était 0,05. Résultats Nous avons colligé 120 patients, représentant 14,6 % de toutes les urgences chirurgicales. L’âge moyen des patients était de 37,6 ± 13,5 ans. Quatre-vingts (66,7 %) étaient de sexe masculin, soit un sex-ratio de 2. Les deux principaux diagnostics préopératoires étaient la péritonite aiguë généralisée (n = 58 soit 48,3 %) et l'occlusion intestinale (n = 38 soit 31,7 %). Les deux principales étiologies des abdomens aigus étaient la perforation d'ulcère gastroduodénal (n = 35) et l'appendicite aiguë (n = 24). Le délai moyen de consultation était de 1,9 jours et en moyenne 36,8 heures s’écoulaient entre le diagnostic et l'intervention chirurgicale. En postopératoire les taux de morbidité et de mortalité étaient respectivement de 33,3 et 10 %. Les complications postopératoires étaient majoritairement mineures selon la classification de Clavien-Dindo soit 21 (33,8 %) de grade I et 12 (19,3 %) de grade II. La principale cause de mortalité était la septicémie (8 cas sur 12). Nous avons identifié sept facteurs statistiquement associés à un risque accru de survenue de complications en postopératoire dont trois modifiables: un délai de consultation supérieur à 72 heures (p = 0,02), un délai entre le diagnostic et l'intervention chirurgicale supérieur à 48 heures (p = 0,01) et une durée d'intervention supérieure à deux heures (p = 0,05). Conclusion Dans notre contexte, les résultats de la prise en charge chirurgicale des abdomens aigus non traumatiques d'origine digestive sont marqués par une morbi-mortalité élevée. Les pistes de solution sont: l'organisation de campagnes de sensibilisation des populations à une consultation rapide en cas de douleurs abdominales aiguës, la mise sur pied d'une couverture sanitaire universelle ainsi que l'amélioration du plateau technique.

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“…Lawson-Ananissoh et al (36) in 2013 noted that health insurance for public agents, by covering a portion of patient expenses, has significantly reduced the direct financial cost of hospital care of cirrhosis. Overall, serious pathologies outside HCC had led to a long hospital stay and benign pathologies aside the bulbar ulcer had led to a short hospital stay; the very reserved prognosis of HCC could explain the short hospital stay of patients hospitalized for HCC unlike other cancers (pancreas, stomach); the hemorrhagic complication of bulbar ulcer could explain the long hospital stay unlike other benign pathologies; hemorrhagic complication is more common in bulbar ulcers than in gastric ulcers (37) . The delay in performing digestive fibroscopy due to financial difficulties or lack of technical support could contribute to increase the length of stay related to gastric cancer.…”

Section: The Evolution Of Different Digestive Pathologies and The Lenmentioning

confidence: 99%

Digestive Diseases in Elderly and Factors Associated With Length of Stay in the Hepatology and Gastroenterology Unit of the Campus Teaching Hospital of Lome (Togo)

Lawson-Ananissoh¹,

Bouglouga²,

Bagny³

et al. 2018

Arq. Gastroenterol.

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BACKGROUND: The digestive pathologies are frequent in the elderly and often have a latent and atypical symptomatology. OBJECTIVE: To assess the epidemiological and evolutionary current data on digestive diseases in the elderly, and look for factors associated with length of hospital stay. METHODS: Retrospective study of 10 years, including patients aged 60 and over hospitalized for digestive diseases in the Gastroenterology Department of the Campus Teaching Hospital of Lome, Togo. RESULTS: Of 5933 hospitalized patients, there were 1054 patients (17.8%) aged 60 years and over with a digestive pathology (526 men and 528 women). The average age was 69.5 years ±7.9 ranging from 60 to 105 years. The average length of hospital stay was 7.45 days ±6.2 ranging from 1 to 44 days. HIV prevalence was 2.4%. In order of decreasing frequency, there were hepatobiliary pathologies (54.3%) with a predominance of cirrhosis and liver cancer, eso-gastroduodenal pathologies (23.1%) with predominance of ulcers, gastric cancer and esophageal cancer, intestinal pathologies (8.7%) with a predominance of food poisoning, pancreatic pathologies (4.2%) with a predominance of pancreatic cancer and peritoneal pathologies (1.4%). Gastric cancer was the second digestive cancer found after liver cancer. Pancreatic head cancer was the second disease after gastric cancer which need a transfer in a surgical ward (P=0.031). There were 204 deaths (19.4%). The longest duration of hospitalization was due to gastric cancer (9.16 days). CONCLUSION: Hepatobiliary diseases were the most frequent and associated with a high death rate and a long hospital stay.

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Hémorragie digestive haute : aspects épidémiologiques et facteurs pronostiques au Burkina Faso (Afrique de l’ouest)

Cited by 7 publications

References 17 publications

At admission hemodynamic instability is associated with increased mortality and rebleeding rate in acute gastrointestinal bleeding: a systematic review and meta-analysis

At admission hemodynamic instability is associated with increased mortality and rebleeding rate in acute gastrointestinal bleeding: a systematic review and meta-analysis

Complications des prises en charge chirurgicales des abdomens aigus non traumatiques d’origine digestive à l’hôpital central de Yaoundé, Cameroun (novembre 2019 - juillet 2020)

Digestive Diseases in Elderly and Factors Associated With Length of Stay in the Hepatology and Gastroenterology Unit of the Campus Teaching Hospital of Lome (Togo)

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