Risk Factors for Mortality Upper Digestive Haemorrhages at the University Hospital Centre of Brazzaville

Abstract

In the absence of interventional endoscopy, the treatment of upper digestive haemorrhages (HDH) at Brazzaville University Hospital is essentially medicinal. The objective of this work was to identify the risk factors for HDH mortality at Brazzaville University Hospital by conducting a retrospective prognostic case-control study over a period of 2 years, from January 2017 to December 2018. The 180 patients included in the study for an HDH were divided into 2 groups according to their evolutionary modality: deceased patients (cases) and non deceased patients (controls). The mortality risk factors were studied by logistic regression. Mortality related to upper digestive haemorrhages was 36.6%; the risk factors for death were age between 30 and 60 years with a (OR: 9.79; 95% CI [1.24 - 76.83]; p = 0.003); male sex (OR: 2.03; 95% CI [1.03 - 4]; p = 0.0393); late consultation beyond 24 hours (OR: 6.30; 95% CI [2.12 - 18.72]; p = 0.0009), blood transfusions (OR: 3.5; 95% CI [1.66 - 7.40]; p = 0.0001). Protective factors were haemoglobin greater than 7 g/dL (OR: 0.28; 95% CI [0.14 - 0.54]; p = 0.0001); treatment with proton pump inhibitors (OR: 0.36; 95% CI [0.15 - 0.84]; p = 0.0191). In conclusion, the reduction of the still high mortality rate in our country requires taking into account the identified risk factors and the acquisition of endoscopic haemostasis equipment.