Abstract
Aim: To describe upper gastrointestinal bleeding (UGB) in Cote d'Ivoire.
Patients and Methods: Multicenter study (university hospital centers of Cocody, Yopougon and Bouake) conducted from first January 2010 to 31 December 2013. Multiple clinical, laboratory and endoscopy parameters were prospectively collected.
Results: 285 patients were included (77% men, mean age 49 years) admitted for melena (82%) with a mean hemoglobin of 6.68 g/dl (transfusion in 78.9% of cases). Systolic blood pressure, diastolic and heart rate averaged were respectively, 104.6 mmHg, 62.1 mmHg and 95.8 beats/min. They had comorbidity in 5.4% of cases, or were taking non steroidal anti-inflammatory (NSAID) drug in 17.3% of cases. A proton pump inhibitor was prescribed on admission in 78.9% of cases. A gastroscopy performed in 91.4%, on average after 72 hours was abnormal in 92.8% of cases (peptic ulcer (41.6%) or gastroesophageal varice (35.3%)). Only variceal ligations were performed. All patients were hospitalized for recurrent bleeding in 4.2% of cases, surgery was performed in 1.4% of cases and 27 patients died (9.4% of cases) by hemorrhagic shock in 40% of cases. Portal hypertension, delay of gastroscopy and active bleeding were independent factors for mortality.
Conclusion: Patients with UGB in Cote d'Ivoire were relatively young, took frequently NSAID in a low technical platform setting. Existence of portal hypertensive and active bleeding are two independent factors for mortality.