Upper gastrointestinal bleeding: epidemiological aspects and prognostic factors in Burkina Faso (Western Africa)

Objective: To establish a general profile of upper gastrointestinal bleeding collected at Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Burkina Faso. Methods: We report the results of our center in the framework of the multicenter prospective study “Upper gastrointesinal bleeding Observatory in French-speaking Africa” and conducted by French-speaking African Association for Continuing Medical Education in Hepato-gastroenterology (www.aaffchge.org), from January 1st to December 30th 2010. Were consecutively included patients who presented at least one of the three symptoms: anemia, hematemesis and melena. Results: Two hundred and sixty-five patients (mean age 46.8±17.1 years) were included with a sex ratio of 2.4. Concomitant hematemesis and melena was the most frequent reason for consultation (50.9%). The use of gastrotoxic drugs was the major bleeding risk factor (37.2%). Endoscopy enabled to come up with a lesion diagnosis (94.8%) with peptic ulcer (52.3%) and esophageal varices (17.6%) as the main causes. The mean clinical Rockall’s score (SR) was 2.0±0.1 and for the full SR 3.2±0.1. Any endoscopic or surgical hemostasis was performed. The further evolution observed was marked mainly by a rebleeding (11.7%) or by a death (17%). The predictive factors of rebleeding were male sex (odds ratio [OR]: 3.1; confidence interval 95% [95% CI] 1.1 to 9.2), hemoglobin below 10 g/ dl in admission (OR: 6.2; 95% CI 1.4 to 26.9) and full SR greater than 2 (OR: 2.8; 95% CI 1.1 to 7.2). Mortality was associated with cirrhosis (OR: 10.8; 95% CI 4.9 to 24.1), hemodynamic shock (OR: 4.7; 95% CI 1.9 to 11.7) and SR clinical greater than 0 (OR: 4.9; 95% CI 1.5 to 16.4).