Causes de Décès de Patients Hospitalisés dans le Service de Médecine Générale de l’Hôpital Nianankoro Fomba de Ségou de 2016 à 2017

ABSTRACT Introduction. The adult mortality rate is a key indicator of a population’s health and a development indicator. The objectives of our study were to report the mortality rate and the causes of death of patients admitted in the general medicine department of Nianankoro Fomba Hospital (HNF) in Segou. Materials and methods. This was a cross sectional retrospective study from January to December 2016 and a prospective study from January to December 2017. Results. During the study period, there were 375 deaths among 1,432 inpatients, i.e. a mortality rate of 26.18%. The sex ratio M/F was 2.05. The average age of deceased patients was 53.48 with extremes of 15 and 96 years. Patients transferred from the emergency department represented 76.40% of cases, and those from the outpatient box 22.80%. Patients from other departments represented 0.80% of cases. Half of the deaths occurred on the first three days of hospitalization. Three out of four patients had no definitive diagnosis at the time of death (only clinical diagnosis). A contributive past history of illness was found in 55% of the patients. Neurological (30.80%), infectious (19.20%) and hepato gastroenterological (13.60%) diseases were the most common causes of death. Cerebrovascular accidents were the main neurological pathology 95.06%. Opportunistic HIV infections accounted for 76.19% of infectious diseases. Cirrhosis represented 91.90% of digestive pathologies. Conclusion. Neurological, infectious and digestive diseases are the main causes of death in our department. However, confirmation of the definite cause of death is difficult in Segou, because of limited availability of radiological and biological equipments... RESUME Introduction. Le taux de mortalite des adultes est un indicateur cle de l’etat de sante d’une population et un indicateur de developpement. Le but de notre etude etait de determiner le taux de mortalite et de rapporter les causes de deces des patients hospitalises dans le service de medecine generale de l’hopital Nianankoro Fomba (HNF) de Segou. Materiels et methodes. Il s’agit d’une etude transversale descriptive retrospective couvrant la periode de janvier a decembre 2016 et prospective de janvier a decembre 2017. Resultats. Durant la periode de l’etude 1432 patients ont ete hospitalises avec 375 deces soit un taux de mortalite de 26,18%. Le sexe ratio etait de 2,05 en faveur des hommes. L’âge moyen etait de 53,48 avec des extremes de 15 et 96 ans. Les patients transferes du service d’accueil des urgences etaient de 76,40 %, ceux du box de consultation externe 22,80% et 0,80% des autres services. Le deces survenait dans la moitie des cas les trois premiers jours de l’hospitalisation. Trois patients sur quatre n’avaient pas de diagnostic de certitude clinique au moment du deces mais un seulement diagnostic. Un antecedent medical contributif a ete retrouve chez 55 % des patients. La pathologie neurologique (30,80%) suivie de la pathologie infectieuse (19,20%) et hepato gastroenterologique (13,60 %) etaient les plus representees. Les accidents vasculaires et cerebraux ont domine la pathologie neurologique 95,06 %. Les infections opportunistes dus au VIH representaient 76,19% des pathologies infectieuses. La cirrhose representait 91,90% des pathologies digestives. Conclusion. Les pathologies neurologiques, infectieuses et digestives sont les principales causes de deces dans notre service. Toutefois, la confirmation de la cause exacte des deces demeure difficile, a cause des moyens d’investigation limites aussi bien radiologiques (tomodensitometrie) ou biologiques.