Pulmonary Embolism: Epidemiological, Clinical, Therapeutic and Evolution Aspects in the Medicine Department of Hospital of Mali Bamako

Massama Konaté,Youssouf Camara,Ichaka Menta,Souleymane Coulibaly,Nouhoum Diallo,Nanko Doumbia,Yacouba Lazare Diallo,Mariam Sako ,Nouhoum Ouologuem ,D.s Sow ,Modibo Mariko ,Soumaila Boubacar ,A Koné ,Coumba Adjaratou Thiam ,I Sangaré ,Aminata Maiga ,Sidikiba Sidibé ,B Traoré ,D Traoré ,Hamidou Oumar Bâ ,Moctar Coulibaly ,Souleymane Mariko ,Mamadou Toure

doi:10.4236/wjcd.2021.114024

Abstract

Background: Pulmonary embolism (PE) is a severe form of venous thromboembolic disease. In Africa, prevalence of PE in hospitalized medical patients varies among studies. Objective: Aim of this work was to study the epidemiological, clinical, therapeutic and evolution aspects of PE in the medicine department of Mali’s Hospital Bamako-Mali. Methodology: This was a retrospective cross-sectional study carried out from January 01, 2017 to December 31, 2020 in the medicine department of Mali’s hospital Bamako, including all inpatients admitted for PE during the study period. Results: Of 1814 hospitalized patients, 54 patients had pulmonary embolism. Hospital frequency of pulmonary embolism was 2.97%. Predominance was female and sex-ratio M/F was 0.38. Mean age in our series was 54.24 ±1.19 years. Predisposing factors to pulmonary embolism were dominated by obesity 37%, high blood pressure 35.2% and history of cardiovascular disease 20.4%. Dominant signs were dyspnoea and chest pain in 83.3% and 70.4% of cases respectively. Probability of pulmonary embolism was high in 40.7% according to Wells score. Patients with right heart failure were 22.2%. EKG showed sinus tachycardia70.4% and S1Q3 aspect 7.4%. Heart right chambers were dilated at transthoracic echography 42.6%. Obstruction was bilateral at chest angio CT for 51.9% and proximal for 42.6%. Deep venous thrombosis was associated at EP in 16.6%. Treatment was low weight molecular heparin followed by vitamin K antagonist or direct oral anticoagulant. One patient was successfully treated by thrombolysis. Hospital mortality was 16.7%. Conclusion: PE is a serious disease probably underdiagnosed. It is responsible of important mortality.

Highlights

Pulmonary embolism (PE) is a severe form of venous thromboembolic disease
Aim of this work was to study the epidemiological, clinical, therapeutic and evolution aspects of PE in the medicine department of Mali’s Hospital Bamako-Mali. This was a retrospective cross-sectional study carried out from January 01, 2017 to December 31, 2020 in the medicine department of Mali’s hospital Bamako, including all inpatients admitted for PE during the study period
In Africa, prevalence of PE in hospitalized medical patients varies among studies between 0.14% to 61.5%, with a mortality rate between 13.7% and 69.5% [2] [3]

Summary

Introduction

Pulmonary embolism (PE) is a severe form of venous thromboembolic disease. Annual incidence of this disease in the world is between 39 and 115 cases for100,000 habitants [1]. Pulmonary embolism (PE) is a severe form of venous thromboembolic disease Annual incidence of this disease in the world is between 39 and 115 cases for. In Africa, prevalence of PE in hospitalized medical patients varies among studies between 0.14% to 61.5%, with a mortality rate between 13.7% and 69.5% [2] [3]. A better understanding of presentation of PE is necessary, so that diagnosis can be made early and treatment initiated. In Africa, prevalence of PE in hospitalized medical patients varies among studies. Predisposing factors to pulmonary embolism were dominated by obesity 37%, high blood pressure 35.2% and history of cardiovascular disease 20.4%. Dominant signs were dyspnoea and chest pain in 83.3% and 70.4% of cases respectively

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Discussion

Conclusion