Pulmonary Embolism in Senegal: Epidemiology, Diagnosis and Management Challenges

Abstract

Introduction: Pulmonary embolism (PE) is a life-threatening condition that represents a major challenge in the management of patients in intensive care. Despite recent advances in prophylactic, diagnostic and therapeutic modalities, PE remains an important cause of morbidity and mortality. Hence the interest of this retrospective study on the management of pulmonary embolism of patients hospitalized in the resuscitation unit of the Peace Hospital of Ziguinchor. Methodology: We conducted a retrospective, descriptive and analytical study covering a period of 32 months from September 2020 to May 2023. The data included variables such as age, gender, clinical symptoms, results of paraclinical tests and treatments administered. Results: The sex ratio was 1.72 with a majority age group of 40-59 years. The average age was 58.93 years for a median age at 58 years. Prolonged immobilization greater than 3 days was the risk factor most found in our patients 33.3% followed by hypertension in 13.3%. Respiratory distress is the main reason for hospitalization in 66.7%. The intermediate clinical probability was most found in our population with 90%. In 53.3% of our patients, the lung damage was unilateral against bilateral for 23.3% at CT-scan. Admission shock was found in 6.7%. In 43.3%, amines were used including noradrenaline at 26.7% and dobutamine at 20%. LMWH were the anticoagulants used in all patients followed by VKA (Acenocoumarol) with 40%. Only 6.7% of our patients were thrombolysed. Mortality was 63.3%. The prognosis according to the PESI score is 53.3% for class 5 and the progressive modalities were poor in 70% of cases. Conclusion: The factors of poor prognosis found are disorders of consciousness, respiratory failure and PESI class 5. This study highlights the urgency of strengthening initiatives for the prevention, diagnosis and treatment of PE. It is vital to work to improve access to thrombolysis in order to reduce mortality and improve quality of life for ......