Pulmonary embolism in Bujumbura

Abstract

Relevance . Pulmonary embolism constitutes a diagnostic and therapeutic emergency. In Africa, data are still difficult to obtain. Thus, the objectives of this work is to describe epidemiological, clinical, therapeutic aspects and short-term outcomes of pulmonary embolism confirmed by thoracic angioscan at Kira hospital in Bujumbura, the biggest city of Burundi with population about 375 000. Patients and Methods . This was a descriptive study of 18 patients who had a pulmonary embolism confirmed by thoracic angioscan in Bujumbura from January 1st, 2015 to December 31st, 2018. We included in our study any patient with pulmonary embolism consenting to participate and processing personal data after some clarified explanations in accordance with the World Medical Association’s Declaration of Helsinki. For each registered patient, we collected socio-demographic, past history of cardiac disease and factors risk, clinical, echocardiographic and scannographic findings with Wells’ score. Variables were presented as means and percentages. Results and Discussion. The average age was 53.5 ± 12.3 years with a sex ratio of 1.25 in favor of women. The modal class was the 50 to 59 age group (33.3%). The clinical probability pre-test by simplified Wells score was high in 66.6% and medium in 33.3% of cases. A history of venous thromboembolic disease was the most common risk factor. Dyspnea was the most reason of consultation with 94.4% of cases. One patient died (5.6%) during hospitalization. Six months after discharge from the hospital, we recorded 3 cases (16.7%) of death, 6 cases (33.3%) of pulmonary heart, 3 cases (16.7%) of recurrent pulmonary embolism and one case of vitamin K antagonist overdose with minor bleeding. Conclusion. Pulmonary embolism is common in relatively young population with a predominance of females and chronic no communicable diseases as risk factors. Examination of a patient with an angioscanner is a sensitive and specific clinical study of pulmonary embolism. The outcome is favorable under appropriate treatment in short term.

About the authors

Eugène Ndirahisha

University of Burundi

Author for correspondence.
Email: kabandaeugene@yahoo.fr
ORCID iD: 0000-0003-3243-1967
Bujumbura, Burundi

Thierry Sibomana

University of Burundi

Email: kabandaeugene@yahoo.fr
Bujumbura, Burundi

Joseph Nyandwi

University of Burundi

Email: kabandaeugene@yahoo.fr
ORCID iD: 0000-0002-3715-7891
Bujumbura, Burundi

Ramadhan Nyandwi

University of Burundi

Email: kabandaeugene@yahoo.fr
ORCID iD: 0000-0003-4371-425X
Bujumbura, Burundi

Sébastien Manirakiza

University of Burundi

Email: kabandaeugene@yahoo.fr
Bujumbura, Burundi

Patrice Barasukana

University of Burundi

Email: kabandaeugene@yahoo.fr
Bujumbura, Burundi

Hermenegilde Nahayo

University of Burundi

Email: kabandaeugene@yahoo.fr
Bujumbura, Burundi

Elysée Baransaka

University of Burundi

Email: kabandaeugene@yahoo.fr
ORCID iD: 0000-0002-7796-6626
Bujumbura, Burundi

References

  1. Meneveau N. L’embolie pulmonaire aux urgences: que disent les recommandations. Presse Med. 2018; 47:784-791.
  2. Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P, Bengel F, Brady AJ, Ferreira D, Janssens U, Klepetko W, Mayer E, Remy-Jardin M, Bassand JP; ESC Committee for Practice Guidelines (CPG). Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J. 2008;18:2276-315. doi: 10.1093/ eurheartj/ehn310.
  3. Touze JE, Moncany G, Amonkou A. La maladie thromboembolique pulmonaire en Côte d’Ivoire (à propos de 13 cas). Med Trop. 1985;45:43-46.
  4. Houenassi M, Sacca-Véhounkpe J, Tchabi Y, Dossou-Yovo RA, Saïzonou F, Biaou O, D’Almeida M, Agboton H. Evaluation de la prise en charge de l’embolie pulmonaire dans un pays à faible niveau socioéconomique: cas du Bénin. Cardiologie Tropicale. 2013;136:1-5.
  5. Wells PS, Anderson DR, Rodger MA and Ginsberg JS, Kearon C, Gent M. Derivation of a simple clinical model to categorize patients’ probability of pulmonary embolism: in creating the models utility with the simpliRED D-dimer. Thromb Haemost. 2000;83 (3):416-20.
  6. Souleymane P et coll. L’embolie pulmonaire au centre hospitalier universitaire Campus de Lomé (Togo): étude rétrospective à propos de 51 cas. Pan Afr medical journal 2015.
  7. Diall IB, Coulibaly S, Minta I, Ba HO, Diakité M, Sidibé N. Etiologie, clinique et évolution de l’embolie pulmonaire à propos de 30 cas. Mali Méd. 2011;26(1):1-6.
  8. Reissig A, Haase U, Schulze E, Lehmann T, Kroegel C. Diagnosis and therapy of pulmonary embolism prior to death. Dtsch Med Wochenschr. 2010;135(30):1477-83.
  9. Olié V, Chin F, Lamarche-Vadel A, De Peretti C. La maladie veineuse thromboembolique: patients hospitalisés et mortalité en France en 2010. Bull Epidémiol Hebd. 2013;(33-34):417-24.
  10. Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, Huisman MV, Humbert M, Jennings CS, Jiménez D, Kucher N, Lang IM, Lankeit M, Lorusso R, Mazzolai L, Meneveau N, Ní Áinle F, Prandoni P, Pruszczyk P, Righini M, Torbicki A, Van Belle E, Zamorano JL; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603. doi: 10.1093/ eurheartj/ehz405.
  11. Reiff DA, Haricharan RN, Bullington NM, Griffin RL, McGwin G Jr, Rue LW 3rd.Traumatic brain injury is associated with the development of deep vein thrombosis independent of pharmacological prophylaxis. J Trauma. 2009;66:1436-40.
  12. Ouldzein H, Nourredine A, Cherradi R, Rahal N, Mechmeche R, Haouala H. Prise en charge de l’embolie pulmonaire en milieu cardiologique: expérience d’un Hôpital tunisien. Annales de cardiologie et d’angéiologie. 2008;57(1):52-57. doi: 10.1016/j. ancard.2007.01.002.
  13. Meneveau N, Vuillemenot A, Bassand J.-P. L’Embolie Pulmonaire. Evaluation clinique démarche diagnostique et stratégie thérapeutique. Boeringer Ingelheim France. R and J. Edition médicale. 1997;11:53-56.
  14. Talavera F, Setnik G, Halamka J. Pulmonary embolism. Besson, E-medicine. 1999.
  15. Ferrari E. Scores de probabilité, diagnostic et stratification du risque de l’embolie pulmonaire. Arch Mal Coeur Vaiss Prat. 2015;247:2-7. doi: 10.1016/j.amcp.2015.07.004
  16. Bahloul M, Chaari A, Kallel H, Abid L, Hamida CB, Dammak H, Rekik N, Mnif J, Chelly H, Bouaziz M. Pulmonary embolism in intensive care unit: Predictive factors, clinical manifestations and outcome. Ann Thorac Med. 2010;5:97-103.
  17. Grifoni S, Olivotto I, Cecchini P, Pieralli F, Camaiti A, Santoro G, Pieri A, Toccafondi S, Magazzini S, Berni G, Agnelli G. Utility of an integrated clinical, echocardiographic, and venous ultrasonographic approach for triage of patients with suspected pulmonary embolism. Am J Cardiol. 1998;82(10):1230-5. doi: 10.1016/s0002-9149(98)00612-2.
  18. Reiff DA, Haricharan RN, Bullington NM, Griffin RL, McGwin G Jr, Rue LW 3rd.Traumatic brain injury is associated with the development of deep vein thrombosis independent of pharmacological prophylaxis. J Trauma. 2009; 66:1436-40.
  19. Vedovati MC, Germini F, Agnelli G, Becattini C. Prognostic role of embolic burden assessed at computed-tomography angiography in patients with acute pulmonary embolism: systematic review and meta-analysis. J Thromb Haemost. 2013;11(12):2092-102.
  20. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet. 1999;353:1386-89.

Copyright (c) 2021 Ndirahisha E., Sibomana T., Nyandwi J., Nyandwi R., Manirakiza S., Barasukana P., Nahayo H., Baransaka E.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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