Résultats et facteurs prédictifs de mortalité des hémorragies digestives hautes en hospitalisation : étude multicentrique en Côte-d’Ivoire

Okon, A. J. B.; Thot’o, A. S.; Diakité, M.; Soro, D.; Ouattara, A.; Koné, A.; Koné, S.; Eloumou, B. S. A. F.; Assi, C.; Allah-Kouadio, E.; Lohoues, K. M. J.; N'dri, N.

doi:10.1007/s10190-015-0508-z

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…L'âge moyen était de 45,34(±16,72) ans, avec une prédominance masculine (sex-ratio H/F=2,64). Ces données sont similaires à celles de Gueye et al (Gueye MN et al, 2021) au Sénégal et Okon et al (Okon AJ et al, 2015) en Côte d'Ivoire. Les facteurs de risque de lésions inflammatoires aiguës ou chroniques oesogastroduodénales (prise de médicaments gastrotoxiques, jeûne) ; et l'évolution lente des hépatopathies chroniques responsables d'hypertension portale expliquent la survenue des hémorragies digestives hautes chez l'adulte jeune.…”

Section: Discussionunclassified

“…Les résultats de cette étude sont identiques à ceux des séries Ouest-Africaines (Katile D et al, 2020;Okon AJ et al, 2015) ; mais diffèrent des données européennes (Cooper GS et al, 2012;Nahon S et al, 2014). L'explication réside dans l'épidémiologie des infections aux virus des hépatites (B et C) qui sévissent en Afrique sub-saharienne sur un mode endémique, avec contamination en période péri-natale.…”

Section: Discussionunclassified

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Facteurs Épidémiologiques et Pronostiques Associés Aux Étiologies Des Hémorragies Digestives Hautes au CHU Campus de Lomé

Bagny

Kogoe²,

Kaaga³

et al. 2021

ESJ

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Objectif : Décrire les aspects épidémiologique, clinique et pronostique associés aux étiologies des hémorragies digestives hautes au CHU Campus de Lomé Patients et méthode: Etude transversale à collecte rétrospective, à visée descriptive et analytique menée du 1er Janvier 2014 au 31 Décembre 2019. Le seuil de significativité était retenu pour p<0,05. Résultats: Deux cent cinquante et un patients avaient été inclus. L’hémorragie était d’origine hypertensive portale chez 69 patients (27,71%) ; ulcéreuse gastro-duodénale chez 100 patients (39,84%). Chez 25 patients (9,96%), la fibroscopie oesogastroduodénale était normale. Une rupture de varices oesophagiennes était retrouvée chez 98,55% des patients présentant une hypertension portale. Les ulcères gastroduodénaux représentaient 54,94% des hémorragies digestives hautes d’origine non hypertensive portale. La valeur moyenne du score de Rockall était de 4(±1) chez les patients présentant une hémorragie d’origine hypertensive et de 3(±1) chez les patients avec hémorragie non hypertensive portale (p<0,001). La valeur moyenne du score de Glasgow-Blatchford était de 10(±3) chez les patients présentant une hémorragie d’origine hypertensive et 9(±3) chez les patients avec hémorragie digestive haute d’origine non hypertensive (p<0,001). La récidive hémorragique et le décès étaient survenus chez les patients présentant un saignement d’origine hypertensive portale dans respectivement 54,84% (p<0,001) et 71,42% (p<0,001). Conclusion: Les lésions inflammatoires aiguës et chroniques représentent la première étiologie des hémorragies digestives hautes dans le service d’Hépato-gastroentérologie du CHU Campus. Ces hémorragies sont associées à la prise de médicaments gastrotoxiques et à un moindre risque de récidive hémorragique et de décès. Objective: To describe epidemiological et prognostic outcomes associated with etiologies upper gastrointestinal bleeding in Campus Teaching Hospital of Lome Patients and method: Cross-sectional study with retrospective collection, descriptive and analytical aim carried out from January 1, 2014 to December 31, 2019. Results: Two hundred and one patients were included. The hemorrhage was of portal hypertensive origin in 69 patients (27.71%); peptic ulcer in 100 patients (39.84%). In 25 patients (9.96%), the oesogastroduodenal fibroscopy was normal. Ruptured esophageal varices were found in 98.55% of patients with portal hypertension. Peptic ulcers accounted for 54.94% of upper GI bleeding of non-portal hypertensive origin. The mean value of the Rockall score was 4(±1) in patients with hemorrhage of hypertensive origin and 3(±1) in patients with non-portal hypertensive hemorrhage (p<0.001). The mean Glasgow-Blatchford score was 10(±3) in patients with hemorrhage of hypertensive origin and 9(±3) in patients with upper GI hemorrhage of nonhypertensive origin (p<0.001). Hemorrhagic recurrence and death occurred in patients with bleeding of hypertensive origin in 54.84% (p<0.001) and 71.42% (p<0.001) respectively. Conclusion: Acute and chronic inflammatory lesions represent the first etiology of upper GI bleeding in the Gastroenterology Department of the Campus Teaching Hospital of Lome. These hemorrhages are associated with the use of gastrotoxic drugs and with a lower risk of recurrence of hemorrhage and death.

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Facteurs Épidémiologiques et Pronostiques Associés Aux Étiologies Des Hémorragies Digestives Hautes au CHU Campus de Lomé

Bagny

Kogoe²,

Kaaga³

et al. 2021

ESJ

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“…Gastrointestinal bleeding must be recognised, its severity assessed, and blood loss compensated. Finally, the cause of the bleeding must be found and treated [1,2,7,11]. The diagnostic approach, non-specific measures to prevent or treat haemorrhagic shock and specific haemostasis measures according to the aetiology of UGIB are often not all implemented in resources limited countries and this has an impact on evolution and prognosis.…”

Section: Introductionmentioning

confidence: 99%

Acute Upper Gastrointestinal Bleeding (UGIB) In A Resource Limited Setting Highly Endemic for Viral Hepatitis B: Which Etiologies for Which Real Clinical Practices?

Ankouane

2021

CTGH

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Aim : To determine the aetiologies of acute upper gastrointestinal bleeding (UGIB) in a setting highly endemic for hepatitis B and to describe actual clinical practices in a resource-limited setting.Patients and methods: This study was conducted in two parts. The first part was retrospective from January 1st 2010, to December 31st 2019 on the epidemiological profile of UGIB and the second was a prospective study from December 1st 2017 to May 31st 2018 to evaluate, in a blinded experiment, the actual clinical practices in front of an acute UGIB at the emergency units in Yaounde (Cameroon), and included: recognizing UGIB, assessing for severity, taking emergency measures and prescribing emergency Eosogastroduodenal endoscopy (EGDE).Results : During the retrospective period, 506 patients (prevalence of acute UGIB in the services 5.6%) were included of which 71.3% were men (sex ratio 2.5). The mean age was 49.9 +/-8 years. Haematemesis was inaugural in 350 patients (69.1%), nonsteroidal anti-inflammatory drugs were the main risk factor in 297 (43.6%), in 78 (15.4%), this was a second episode. Clinical parameters showed initial instability in 435 patients (85.9%) and haemoglobin (Hb) was <7g/dl in 359 (83.4%). EGDE was performed in 203 patients (40.2%), the main causes of UGIB were lesions of portal hypertension in 111 (44.7%), followed by peptic ulcers in 108 (43.5%). Treatment was mainly medical. However, 94 patients (84.7%) with portal hypertension lesions received endoscopic treatment, mainly by injection of sclerosing agent (69.1%), as well as 13 (1.2%) with peptic ulcers, mainly by isolated injection of dilute adrenaline (1: 10,000) in 11 (84.6%). A total of 75 patients (14.8%) died. The second part concerned 74 patients admitted for acute UGIB at the emergency services of five hospitals in Yaounde. To recognize UGIB, a digital rectal examination was done in 43 patients (58.1%), no patient received a nasogastric tube. For assessment of severity, blood pressure was taken in 73 patients (98.6%), pulse rate in 61 (82.4%), respiratory rate in 17 (23%), saturation in 17 (23%), no patient had prognostic scores in their record. For resuscitation measures, 10 patients (13.5%) received a double peripheral venous line, 20 (27%) were filled with crystalloids, restrictive blood transfusion (Hb < 7 g /dl) was carried out in 24 out of 27 patients (88.9%), 9 (12.2%) received nasal oxygen therapy. EGDE was carried out in 43 patients (60.6%), all beyond 24 hours and none had a prognostic score (Forrest or Rockall).

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The prognostic significance of the Rockall score evaluation in patients admitted for upper gastrointestinal bleeding in Yaoundé (Cameroon)

Ndjitoyap Ndam,

Ayissi Mete,

Nsenga Djapa

et al. 2023

NJGH

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Background and Objectives: Upper gastrointestinal bleeding (UGIB) is a major emergency. The Rockall score (RS) could be a tool to predict the outcome of patients regarding their risk of re-bleeding and/or death 30 days after admission. This study aimed to evaluate the prognostic value of the RS in patients admitted for UGIB in Yaoundé (Cameroon). Materials and Methods: We conducted a retrospective cohort study at two emergency units inYaoundé. We included 101 patients admitted from 2020 to 2021 for a UGIB and obtained the sociodemographic, clinical, and paraclinical data. The outcome 30 days after the admission was assessed (re-bleeding and/or death). We calculated the RS and analyzed the association of an RS ≥ 5 with the death of the patient and/or a re-bleeding 30 days after admission. Results: The mean age of patients was 48.5 years, 75 of the 101 were males (74.3%). The main bleeding lesions were portal hypertension in 35 patients (34.7%), gastric ulcers in 32 patients (31.7%), and duodenal ulcers in 30 patients (29.7%). During the 30 days after the admission, we recorded re-bleeding in 21 patients (20.8%) and death in 9 patients (8.9%). The RS was ≥ 5 in 49 patients (48.5%), and this was significantly associated with the re-bleeding (RR 4.5; CI 95% 1.631–12.459; P = 0.001) and with the death (P = 0.001). Conclusion: The RS ≥ 5 is associated with a risk of re-bleeding and/or death in patients admitted for a UGIB in Yaoundé regardless of the aetiology.

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Résultats et facteurs prédictifs de mortalité des hémorragies digestives hautes en hospitalisation : étude multicentrique en Côte-d’Ivoire

Cited by 4 publications

References 17 publications

Facteurs Épidémiologiques et Pronostiques Associés Aux Étiologies Des Hémorragies Digestives Hautes au CHU Campus de Lomé

Facteurs Épidémiologiques et Pronostiques Associés Aux Étiologies Des Hémorragies Digestives Hautes au CHU Campus de Lomé

Acute Upper Gastrointestinal Bleeding (UGIB) In A Resource Limited Setting Highly Endemic for Viral Hepatitis B: Which Etiologies for Which Real Clinical Practices?

The prognostic significance of the Rockall score evaluation in patients admitted for upper gastrointestinal bleeding in Yaoundé (Cameroon)

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