Prévalence et Facteurs Associés à la Mortalité Intra-Hospitalière des Patients ayant une Insuffisance Cardiaque dans deux Hôpitaux de Référence de Yaoundé

RESUMEIntroduction. l’insuffisance cardiaque (IC) est une cause frequente de deces intra-hospitalier liee aux maladies cardiovasculaires en Afrique. Elle represente l’evolution ultime de la plupart des pathologies cardiaques. Sa prevalence ne cesse de croitre du fait du vieillissement de la population et du meilleur pronostic des diverses maladies qui conduisent a l’insuffisance cardiaque tels que la maladie coronaire et l’hypertension arterielle. L’objectif de cette etude etait de determiner la prevalence et les facteurs associes a la mortalite intra-hospitaliere des patients ayant une IC dans deux hopitaux de reference de la ville de Yaounde. Methodologie. Nous avons mene une etude transversale retrospective dans les services de cardiologie de l’Hopital Central et de l’Hopital General de Yaounde sur une periode de 3 ans. Nous avons inclus les dossiers des patients de 18 ans et plus, hospitalises pour IC. L’analyse statistique a ete faite grâce au logiciel Epi Info version 7.1 et le seuil de significativite etait fixe a 5%. Resultats. La prevalence hospitaliere de l’IC pendant la periode d’etude etait de 40,8%. L'âge moyen des patients etait de 66 ± 15 ans. La prevalence de la mortalite intra-hospitaliere etait de 16,4%. Les facteurs independamment associes a la mortalite intra-hospitaliere etaient : l’hypotension arterielle (OR=5,7[2,5-12,9] ; p<0,01), l’indisponibilite du traitement intra-hospitalier (OR=10,6[5,6-19,8] ; p<0,01), la clairance de la creatinine (ClCr) < 30ml/min (OR=2,5[1,1-5,5] ; p=0,02) et l’alteration severe de la fraction d’ejection du ventricule gauche (FEVG) (OR=6,7[3,7-12,1] ; p<0,01). Conclusion. L’IC est une cause frequente d’hospitalisation en Cardiologie a Yaounde. La mortalite intra-hospitaliere y est importante et est associee a l’hypotension arterielle, l’indisponibilite du traitement intra-hospitalier, une ClCr < 30ml/min et une alteration severe de la FEVG. ABSTRACTIntroduction. Heart Failure (HF) is a common cause of in-hospital death related to cardiovascular disease in Africa. It represents the ultimate course of most heart conditions. Its prevalence is increasing due to the ageing of the population and the better prognosis of the various diseases that lead to heart failure such as coronary heart disease and hypertension. The objective of this study was to determine the prevalence and factors associated with intra-hospital mortality of patients with heart failure in two reference hospitals in the city of Yaounde, The aim of our study was to determine the prevalence and factors associated with intra-hospital mortality of patients with heart failure in two reference hospitals in Yaounde. Methodology. We conducted a retrospective cross-sectional study in the cardiology departments of the Yaounde Central Hospital (HCY) and the Yaounde General Hospital (HGY). The data were collected over a period of 3 years. We included the records of patients over 18 years of age hospitalized for heart failure during the study period. The variables collected were socio-demographic characteristics, clinical entry and paraclinical examination data, and evolving data. The statistical analysis was performed using the Epi-Info software version 7.1. A p-value <0.05 was considered statistically significant. Results. The hospital prevalence of heart failure during the study period was 40.8%. The average age of the patients was 66 ± 15 years. The prevalence of in-hospital mortality was 16.4%. The factors independently associated with in-hospital mortality were: hypotension (OR=5.7[2.5-12.9] ; p<0.01), unavailability of intra-hospital treatment (OR=10.6[5.6-19.8] ; p<0.01), creatinine clearance <30ml/min (OR=2.5[1.1-5.5] ; p=0.02), and severe alteration of the left ventricular ejection fraction (LVEF) (OR=6.7[3.7-12.1] ; p<0.01). Conclusion. Heart failure is a frequent cause of hospitalization in Cardiology in Yaounde. Intra-hospital mortality is high and the factors associated with this mortality were: low blood pressure, unavailability of intra-hospital treatment, creatinine clearance <30ml/min, and severe alteration of LVEF.