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Etudier le profil des patients hospitalisés pour hémorragie sous traitement anticoagulant. Il s’est agi d’une étude rétrospective à visée descriptive sur une période de 02 ans allant du 1er Janvier 2007 au 31 Décembre 2008, dans le Service de Cardiologie du Centre Hospitalier Universitaire-Yalgado Ouédraogo. Tous les patients hospitalisés présentant une hémorragie sous anticoagulant ont été inclus dans l'étude. L’âge moyen des patients était de 49,31 ± 17,68 ans, le sex-ratio était de 2,17. L’infarctus du myocarde était la première indication du traitement anticoagulant avec une fréquence de 21,05%. L’anti Vitamine K (AVK) a été pourvoyeur d’hémorragies dans 63,16% (n = 12) des cas contre 36,84% (n = 7) pour les Héparines de Bas Poids Moléculaire (HBPM); Il s’agissait de 10 cas d’hémorragie majeure et de neuf cas d’hémorragie mineure. La durée moyenne du traitement AVK était de 16 semaines ± 58 semaines. Le saignement par le tractus digestif était le plus fréquent (31,58%) et dans 89,47% des cas, le traitement était associé à un antiagrégant plaquettaire. L’arrêt définitif de l’anticoagulant constituait la prise en charge de l’accident hémorragique dans 73,68%. Il y avait quatre (21,05%) décès. L’inaccessibilité des antidotes comme le sulfate de protamine et les PPSD (Prothrombine Proconvertine Stuart B) constituent un véritable frein à la prise en charge adéquate des complications; mais une meilleure éducation de patients utilisateur de ces drogues constituerait la plus importante des préventions, car plus de 50% de ces accidents sont évitables.

To evaluate the performance of the 4PEPS score in the diagnosis of pulmonary embolism at the University Hospital of Bogodogo from January 1, 2021 to July 31, 2023. This was a cross-sectional descriptive and analytical diagnostic study, running from January 1, 2021 to July 31, 2023. It took place in the infectious and tropical diseases departments, including a pneumology unit and a cardiology unit, of the Bogodogo University Hospital. Patients of both sexes with suspected pulmonary embolism who had undergone CT scan were included. The 4PEPS score was calculated and dichotomized into probable and improbable. It thus constituted the diagnostic test. CT scan was the gold standard. The accuracy of the diagnostic test was judged by the area under the ROC curve. An area under the curve between 0.70 and 1 would mean that the score was moderately informative to perfect. Our study included 472 patients with suspected pulmonary embolism out of a total population of 1228 patients. Hospital prevalence was 21.7%. The mean age of patients was 54.3 years. Females accounted for 52.1% of cases, with a sex ratio of 0.93. The prevalence of pulmonary embolism in the different probability levels of the 4PEPS score was 13.3% for the very low level, 11.7% for the low level, 84.6% for the intermediate level and 93.3% for the high level. Sensitivity and specificity were 92.1% and 86.82% respectively. The positive and negative predictive values were 90.1% and 89.4% respectively. The area under the ROC curve was 0.91. In our study, the 4PEPS score showed good negative and positive predictive values. The use of this score will enable practitioners faced with diagnostic difficulties to make therapeutic decisions, reducing inappropriate prescriptions for thoracic angioscan. [ABSTRACT FROM AUTHOR]

the study's objective was to determine impact of COVID-19 on the prognosis of pulmonary embolism. An analytical multicenter cross-sectional study with retrospective data collection was carried out in three university hospitals and a private clinic in Ouagadougou from March, 2020 to July 2021. It included consecutive patients hospitalized for PE confirmed on chest CT angiography or by the association an acute cor pulmonale on echocardiography-Doppler with deep vein thrombosis on venous ultrasound-Doppler of the lower limbs and having carried out a COVID-19 test (RT-PCR or rapid diagnostic test). Control cases consisted of all COVID-19 negative PE cases. Data comparison was carried out using the Epi info 7 software. A univariate then multivariate analysis allowed the comparison of the prognosis of the two subpopulations. The significance level retained was p < 0.05. 96 patients with COVID-19+ and 70 COVID-19- PE were included. The prevalence of PE in patients hospitalized for COVID-19 was 7.05%. The average patient age was 61.5±17 years for COVID-19+ patients and 49.6±15.9 years for COVID-19- patients. Pulmonary condensation syndrome (p =0.007), desaturation (p =0.0003) and respiratory distress syndrome (p =0.006) were more common in COVID-19+ patients. The hospital death rate was 27.1% in COVID-19+ patients and 10% in COVID-19- patients (p =0.0024). Age > 65 years and COVID-19 pneumonia were the independent factors of death. COVID-19 is associated with clinical severity and excess mortality in patients with pulmonary embolism. [ABSTRACT FROM AUTHOR]

Résumé Objectifs L'objectif de cette étude a été d'étudier le profil évolutif des syndromes coronaires aigus (SCA) en fonction des scores de risque GRACE, TIMI et SRI chez les patients hospitalisés dans le service de cardiologie du centre hospitalier universitaire Yalgado Ouédraogo (CHU YO). Patients et méthodes Il s'agit d'une étude prospective monocentrique de 111 patients consécutifs admis pour SCA (âge moyen de 57,61 ans, 77,5 % de sexe masculin) entre le 1er janvier 2010 et le 31 mai 2015. Résultats La prévalence des SCA était de 4,2 %. Les patients étaient admis pour SCA ST+ et SCA non ST+ dans respectivement 88,3 % et 11,7 %. Dix-neuf patients (17,1 %) étaient admis avant la 12e heure. La mortalité hospitalière était de 8,1 % et passait à 16,2 % en un mois. Après stratification du risque, la survie à un mois des patients à risque élevé, était plus courte que celle des patients à risque faible quel que soit le score GRACE (log-rank = 9,93 ; p = 0,007), TIMI (log-rank = 14,91 ; p = 0,001) et SRI (log-rank = 10,01 ; p = 0,006). Les scores GRACE (HR = 1,01 ; p = 0,002), TIMI (HR = 1,33 ; p = 0,01) et SRI (HR = 1,02 ; p = 0,01) étaient des facteurs pronostiques majeurs de survie globale. Conclusion Les SCA demeurent une pathologie grave avec une morbi-mortalité élevée dans les jours qui suivent l'accident initial. Ces scores de risque sont des outils applicables au Burkina Faso comme en atteste la statistique C (GRACE = 0,75, TIMI = 0,78 et SRI = 0,74). Abstract Objectives The aims of this study was to assess evolution profile of acute coronary syndrome (ACS) based on risk level by GRACE, TIMI and SRI scores in the cardiology department, Yalgado Ouedraogo university hospital. Patients and methods This was a prospective study of 111 consecutive patients admitted for ACS (mean age 57.61 years, 77.5% male) between January 1st and 2010 to May 31st 2015 in the department of cardiology. For each patient, risk scores were calculated and they were divided into risk group. Global survival at one month was described by Kaplan Meier method and prognostic factors were analyzed by multivariable Cox regression. Results The prevalence of ACS was 4.2%. Patients were admitted for ST-elevation ACS and non-ST-elevation ACS in 88.3% and 11.7%, respectively. Nineteen patients (17.1%) were admitted before the 12th hour. Hospital mortality was 8.1% and increased to 16.2% in one month. After risk stratification, one-month survival of patients with high risk, was shorter than patients at low-risk regardless of the score GRACE (log-rank = 9.93, P = 0.007), TIMI (log-rank = 14.91, P = 0.001) and SRI (log-rank = 10.01, P = 0.006). GRACE score (HR = 1.01; P = 0.002), TIMI (HR = 1.33; P = 0.01) and SRI (HR = 1.02; P = 0.01) were major prognostic factors for overall survival. Conclusion ACS remains a serious disease with high morbidity and mortality in the days following the initial accident. These risk scores are applicable tools in Burkina Faso as evidenced statistic C (GRACE = 0.75, TIMI = 0.78 and SRI = 0.74). [ABSTRACT FROM AUTHOR]