The prognostic significance of the Rockall score evaluation in patients admitted for upper gastrointestinal bleeding in Yaoundé (Cameroon)

Author:

Ndjitoyap Ndam Antonin Wilson12,Ayissi Mete Michèle3,Nsenga Djapa Guy Roger4,Nga Bekolo5,Chipekam Ndjifoum Moselle1,Kowo Mathurin1,Ankouane Andoulo Firmin16

Affiliation:

1. Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon

2. Hepatogastroenterology Service, Yaoundé General Hospital, Yaoundé, Cameroon

3. Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon

4. Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences, University of Dschang, Dschang, Cameroon

5. Department of Internal Medicine, University of Mountain, Bangangté, Cameroon

6. Hepatogastroenterology Service, Yaoundé Central Hospital, Yaoundé, Cameroon

Abstract

Abstract Background and Objectives: Upper gastrointestinal bleeding (UGIB) is a major emergency. The Rockall score (RS) could be a tool to predict the outcome of patients regarding their risk of re-bleeding and/or death 30 days after admission. This study aimed to evaluate the prognostic value of the RS in patients admitted for UGIB in Yaoundé (Cameroon). Materials and Methods: We conducted a retrospective cohort study at two emergency units inYaoundé. We included 101 patients admitted from 2020 to 2021 for a UGIB and obtained the sociodemographic, clinical, and paraclinical data. The outcome 30 days after the admission was assessed (re-bleeding and/or death). We calculated the RS and analyzed the association of an RS ≥ 5 with the death of the patient and/or a re-bleeding 30 days after admission. Results: The mean age of patients was 48.5 years, 75 of the 101 were males (74.3%). The main bleeding lesions were portal hypertension in 35 patients (34.7%), gastric ulcers in 32 patients (31.7%), and duodenal ulcers in 30 patients (29.7%). During the 30 days after the admission, we recorded re-bleeding in 21 patients (20.8%) and death in 9 patients (8.9%). The RS was ≥ 5 in 49 patients (48.5%), and this was significantly associated with the re-bleeding (RR 4.5; CI 95% 1.631–12.459; P = 0.001) and with the death (P = 0.001). Conclusion: The RS ≥ 5 is associated with a risk of re-bleeding and/or death in patients admitted for a UGIB in Yaoundé regardless of the aetiology.

Publisher

Medknow

Reference16 articles.

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3. The clinical features and outcome of patients admitted with acute upper gastrointestinal bleeding in the General Hospital Douala, Cameroon: A cross sectional analysis;Luma;Revue Africaine de Chirurgie et Spécialités,2011

4. Comparison of prognostic scores for upper gastrointestinal bleeding in the Hepato-Gastro-Enterology Department of Campus Teaching Hospital of Lome;Bagny;Open J Gastroenterol,2021

5. Risk assessment after acute upper gastrointestinal haemorrhage;Rockall;Gut,1996

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