A SIMO^1,2,  A  DZUDIE^2,3,4,5,7, Y MAPOURE^4,6,7,

 R HENTCHOYA⁷,F KAMDEM^4,7, A KANA⁷, H LUMA^4,8.

Institut Supérieur des Sciences de la Santé, Université des Montagnes, Bangangte, Cameroon.

Clinical Research Education, Networking and Consultancy-CRENC, Douala, Cameroon.

Faculty of Health Sciences, University of Buea, Cameroon.

Department of Internal Medicine, Douala General Hospital, Douala, Cameroon.

Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.

Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.

General intensive care unit, Douala General Hospital, Douala, Cameroon.

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

Adresse pour correspondance: Anastase Dzudie, MD, PhD, FESC. P.O Box 4856, Douala General Hospital, Cameroon. Tel: 00237679617981; Email: Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser.

Introduction: Cardiovascular diseases are the leading cause of morbidity and mortality worldwide and most of these usually present in the clinical setting as emergencies. In Sub-Saharan Africa, limited reports suggest cardiovascular death rates are similar to or higher compared to the rest of the world.

Objective: Evaluate the morbidity and mortality of patients with cardiovascular emergencies and the factors associated in-hospital mortality at the Cardiovascular Intensive Care Unit, Douala General Hospital since its inception in 2012.

Methods: A retrospective cohort study spanning 2.5 years (October 2012 - December 2014) was conducted for 6 months (February to August 2015). Patients aged ≥18years hospitalized as cardiovascular emergencies, having a complete medical file were included. Data on sociodemographic, clinical profiles and intra-hospital outcome were collected. Kaplan-Meier Curves were plotted for probability of mortality and survival, then, compared using the Log rank test to determine factors associated with in-hospital mortality via SPSS 20.

Results: Cardiovascular emergencies represented 4% (333/8325) of all medical emergencies. The mean age was 62 years with 53.2% (177/333) males, sex ratio (M:F) of 1.13:1. The presenting features at the emergency room were dyspnea (44.5%) and hemi paresis (22.1%). The most common aetiologies were acute heart failure (25.2%) and ischemic stroke (24.6%), while cardiac tamponade (1.2%) and aortic dissection (0.6%) were rare. In-hospital mortality was 31.8%. Haemorrhagic stroke (10.2%) and acute heart failure (6.6%) were the most lethal.
Factors associated with in-hospital mortality were the occurrence of complications (p<0.001), a Glasgow score below 7 (p<0.001), the presence of at least two cardiovascular risk factors ((p < 0.05),) and late referral to hospital (p < 0.01).

Conclusion: About 1 in 3 patients die following hospitalization at the cardiovascular intensive care unit of the Douala General Hospital. This high mortality may reflect growing burden of cardiovascular diseases and the need for awareness and preventive measures in the region.

Key words: mortality, morbidity, predictors, cardiac emergencies, intensive care unit