Les urgences ORL à l’Hôpital Général de Douala

Resume Les urgences sont des situations courantes en Otorhinolaryngologie. La prevention est le meilleur moyen de reduire leurs frequences afin d’en limiter les complications. L’objectif general de cette etude etait de decrire le profil epidemiologique des urgences ORL dans le service d’ORL de l’Hopital General de Douala. Materiel et methode : Pour atteindre cet objectif, nous avons mene une etude descriptive longitudinale retrospective sur les dossiers des patients presentant des urgences ORL recus dans ce service de Janvier 2010 a Decembre 2014. Les donnees ont ete analysees a l’aide du logiciel Epi-info version 3.5.4. Les analyses ont consiste essentiellement au calcul des proportions avec un intervalle de confiance de 95% pour les variables qualitatives. Nous avons utilise le test exact de Fisher pour comparer les proportions et nous avons considere une difference statistiquement significative pour une valeur p inferieur a 0,05. Resultats : 18351 patients ont ete recu dans le service d’ORL de l’Hopital General de Douala. Parmi ceux-ci 428 ont presente des urgences soit une incidence hospitaliere de 2,33%. L’âge moyen etait de 34,19±19,92 ans avec 20% d’enfants de moins de 15 ans. Les sujets de sexe masculin representaient 60% de la population d’etude avec un sex ratio de 1,5:1. Le traumatisme maxillo-facial etait la principale cause d’urgence avec une frequence de 23% suivit par le vertige positionnel paroxystique benin (12,8%) et les corps etrangers (9,3%). Les accidents de la voie publique representent 91% circonstances de survenue de ces urgences. Nous avons enregistre dans notre serie 6% d’urgences vitales. La totalite des patients a recu un traitement et une intervention chirurgicale a ete requise dans 34% des cas. Les complications observees (6,3%) etaient exclusivement esthetiques et fonctionnelles. Il a ete note 2 cas de deces soit un taux de mortalite de 0,5%. Conclusion : La morbidite liee aux urgences ORL a l’Hopital general de Douala est faible mais la demande en soin de haute performance (intervention chirurgical) y est elevee ainsi que la frequence des complications. Ces urgences sont dominees par les traumatismes maxillo-faciaux. Abstract Background: Emergencies are frequent in the ENT department and prevention is the best way to reduce their frequency. The objective of this study was to describe the epidemiological and clinical profiles of ENT emergencies as well as identify their management strategies in a reference hospital in Cameroon. Methods: We conducted a longitudinal documentary review of patient’s files over a period of five years (January 2010 to December 2014) in the Douala General Hospital of Cameroon. The data was collected using a data extraction sheet and analysed using the statistical software Epi-Info version 3.5.4. Major analyses were calculation of proportions and their 95% confidence intervals for qualitative variables and calculation of means for quantitative variables. We use Fisher exact test to compare proportions and the difference was statistically significant when p value was less than 0.05. Results: A total of 18.351 patients were received in the ENT department of the Douala Regional Hospital with a mean age of 34.2±19.9 years. It was estimated that up to 20% of these patients were aged below 15 years and the most represented age group was the 30-45 years age group. The population was dominated by males with a sex ratio of 1.5:1. Out of the total number of patients consulted, 428 (2.33%) were received with at least one ENT emergency. The leading causes of ENT emergencies included the following; maxillofacial trauma (23.1%), positional paroxystic vertigo (12.8%), and Foreign body (9.3%). Road traffic accident was associated with up to 91% of the ENT emergencies. In our study, 6% of cases were vital emergencies. All the patients were treated and surgery was required in 34% of cases. The complications (6.3%) were exclusively aesthetic and functional. Mortality rate was 0.5%. Conclusion: The morbidity associated to ENT emergencies at the Douala General hospital is low but the demand for high performance care (surgery) is considerably elevated, as well as the frequency of the complications too. Maxillofacial trauma is the most common cause of these emergencies