Morbidity and Mortality of Patients Admitted with Cardiovascular Emergencies at the Vascular Intensive Care Unit of the Douala General Hospital, Cameroon .

CaHReF 2016, Yaoundé Conges hall, 23 – 26 August 2016 , PL151

Cardiovascular diseases are the leading cause of morbidity and mortality worldwide and most of these usually present in the clinical setting as emergencies. In Sub-Saharan Africa, limited reports and management of these emergencies rarely done in specialized units suggest cardiovascular death rates are similar to or higher compared to the rest of the world.

Determine the morbidity and mortality of patients admitted with cardiovascular emergencies and the factors associated in-hospital mortality at the Vascular Intensive Care Unit of the Douala General Hospital since its inception in 2012.

A retrospective cohort study spanning 2.5 years (October 2012 - December 2014) was conducted for 6 months (February to August 2015). Patients aged ≥18years hospitalized as cardiovascular emergencies, having a complete medical file were included. Data on sociodemographic, clinical profiles and intra-hospital outcome were collected. Kaplan-Meier Curves were plotted for probability of mortality and survival, then, compared using the Log rank test to determine factors associated with in-hospital mortality via SPSS 20.

Cardiovascular emergencies represented 4% (333/8325) of all medical emergencies. The mean age was 62 years with 53.2% (177/333) males, sex ratio (M:F) of 1.13:1. The presenting features at the emergency room were dyspnea (44.5%) and hemi paresis (22.1%). The most common aetiologies were acute heart failure (25.2%) and ischemic stroke (24.6%), while cardiac tamponade (1.2%) and aortic dissection (0.6%) were rare. In-hospital mortality was 31.8%. Haemorrhagic stroke (10.2%) and acute heart failure (6.6%) were the most lethal.
Factors associated with in-hospital mortality were the occurrence of complications (p=0.01), a Glasgow score below 7 (p=0.01), the presence of at least two cardiovascular risk factors (p=0.04), and late referral to hospital (p=0.001).
Conclusion: Cardiovascular emergencies are common in our environment. About 1 in 3 patients die following hospitalization at the Vascular intensive Care Unit of the Douala General Hospital. This high mortality may reflect growing burden of cardiovascular diseases and the need for awareness of of our government in order to optimize the efficacy of our health system face to that threat, and preventive measures in the region.

Morbidity, Mortality, Cardiovascular Emergency, Vascular Intensive Care Unit