ETUDE DE LA MORTALITE POST OPERATOIRE AU SERVICE DE CHIRURGIE GENERALE DU CHU DE L’AMITIE SINO-CENTRAFRICAINE A BANGUI, RCA

Abstract

Goal: To determine the postoperative mortality rate, identify the main causes and factors of postoperative morbidity and mortality in the general surgery department. Patients and method: This was a retrospective descriptive study covering the period from January 1, 2010 to December 31, 2019. The files of patients who died within 30 days following a surgical procedure were used. Results: A total of 812 deaths were recorded for 6,800 patients operated on in 10 years, or 11.9%. Only 200 files meeting the selection criteria were analyzed. The average number of deaths per year was 20 cases. The series included 63% male subjects. The average age was 41.4 years and the majority of deceased patients (51.5%) resided in Bangui. There were much more unemployed people (28%) and housewives (24.5%). Most deaths (82%) occurred after emergency surgery where acute generalized peritonitis (34%) and acute intestinal obstruction (25%) were the main indications. In 83% of cases, the deceased patients had a comorbidity, predominantly HIV infection (33.5%). The deceased patients were classified as ASA IV (45.5%) and Altémeier type III (34%). Postoperative deaths (80%) occurred in surgical intensive care 7 days on average after the operation following septic shock (55%). Conclusion: Post-operative mortality in Bangui remains high. It involves emergency surgery. The reorganization of emergency and surgical resuscitation services will help reduce this mortality rate.