TITLE:
Venous Thromboembolic Disease in the Cardiology Department of the Nianakoro Fomba Hospital in Segou (HNF)
AUTHORS:
Mariam Sako, Mamadou Touré, Boureima Dembélé, Yves R. Koumaré, Massama Konaté, Mamadou Diakité, Coumba Thiam, Aniessa Kodio, Samba Sidibé, Asmaou Keita, Aichata Dao, Youssouf Camara, Boubacar Sonfo, Bassirima Traoré, Souleymane Mariko, Souleymane Coulibaly, Ichaka Menta
KEYWORDS:
Venous Thromboembolic Disease, Nianakoro Fomba-Ségou-Mali Hospital
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.12 No.11,
November
30,
2022
ABSTRACT: Venous thromboembolic disease (VTE) is a nosological group that consists mainly of deep vein thrombosis (DVT) and pulmonary embolism (PE). The objective of our study was to determine the hospital prevalence of VTE in this Nianakoro Fomba Regional Hospital (HNF) in Ségou, Mali, to describe the sociodemographic aspects of these patients and the therapeutic possibilities in this locality. Materials and Methods:We conducted a prospective descriptive study from June 2019 to June 2020 in the cardiology department of the HNF of Ségou. All patients of all ages and both sexes who had VTE on clinical and paraclinical criteria (pulmonary Angio scan and/or venous Doppler echo) during the study period were included. Result:31 patients were included out of 366 hospitalized patients, with a hospital prevalence of 8.47%. The 41-60 and 61 - 80 age groups were both dominant with 35.48% of cases each. The female sex was the most represented with 58.06% of cases and a sex ratio of 0.97. High blood pressure (hypertension) was the preeminent cardiovascular risk factor in32.2% of cases and predisposing factors for VTE were dominated by immobilization (41.94%), peripartum (16.13%) and heart failure (16.13%). Dyspnea and chest pain were the frequent reasons for consultation with 93.54% and 83.87% of cases respectively and 6 patients (19.35%) had calf pain. More than 3/4 of the patients had tachypnea or 90.32% and tachycardia in nearly 74.19%. The clinical probability of VTE was intermediate at51.61% according to the Wells score. D-Dimers were elevated in 38.70%, or all 12 patients who performed it. The electrocardiogram (ECG) recorded a sinus rhythm in 93.54% of cases, a right branch block and atrial fibrillation (AF) in 35.48% and 6.45% of cases, respectively. Dilation of the right ventricle was present in 64.51% of cases with PAH in 61.29% on cardiac Doppler ultrasound. In the majority of cases (82.15%) it was a massive bilateral proximal and distal pulmonary embolism. Treatment was based on low molecular weight heparin (HPBM) and antivitamin K (AVK) in all patients (100%). No bleeding incidents; the average hospital stay was 10 days and an intra-hospital mortality rate of 29%.