Vol 4-1 Research Article

A Cross Sectional Study Comparing Blood Parameters for Short Term Adverse Outcome in Syncope Patients

Farizan Tajudin, Nik Azlan Nik Muhamad*

Emergency Department, Medical Centre, National University of Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia

Introduction: Mortality from syncope may not be apparent on initial evaluation in emergency department (ED). No reliable tools or clinical decision rule was established risk stratify mortality or morbidity from syncope. This study relates blood parameters with short term serious outcome of syncope. Methods: This was a single centre case control study of adults presenting to emergency department with syncope (n = 98), over 3 months’ duration. Patients particulars, contact profile and blood investigation results were recorded. Patients were called up to ascertain development of serious outcome of syncope within 7 days. Blood parameters such as hemoglobin, hematocrit, serum urea, serum sodium and Troponin I were compared between serious outcome and non-serious outcome group. Result: There was significant difference (p < 0.05) in hemoglobin, hematocrit, serum urea and Troponin I level between the 2 groups of syncope patients. Lower hemoglobin (11.5 ±3.4 g/dL vs. 13.0 ±2.1 g/dL) and lower hematocrit level (34.5 ±9.1 % vs. 38.8 ±5.8 %) were associated with development of short-term serious outcome after syncope. Higher serum urea (9.3 ±8.0 mmol/L vs. 4.3 ±1.2 mmol/L) and abnormally elevated Troponin I (x2 = 15.77; p < .001) were associated with development of short-term serious outcome after syncope. Conclusion: The parameters studied can be a baseline guide for disposition of syncope patient in ED. Further interventional prospective studies are required.

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Vol 4-1 Original Research Article

COVID-19 Comorbidity and Non-Communicable Diseases (NCDs) General Reference Hospital (HGR), Niamey, Niger

MAHAMANE SANI Mahamane Aminou1, GBAGUIDI Aichatou Diawara2, MIGITABA Hassane Moctar1, SANI Rabiou1, EMOUD TCHOLI Idrissa3, SALIFOU ALKASSOUM Ibrahim3, FOUMAKOYE GADO Adamou4, BATOURE Oumarou2, OCQUET Sakina5, BRAH Souleymane6, MOUSSA SALIA Amadou6, OUMARA Maman6, TAMBWE Didier2, ANYA Blanche2, Ngozi Idemili-Aronu7, IGWEONU Obianuju7, DANGOU Jean-marie8, ADEHOSSI Eric6, OKEIBUNOR Joseph Chukwudi8, TALISUNA Ambrose8

1Service Endocrinologie, Diabétologie et Nutrition de l’Hôpital Général de référence de Niamey ; BP: 12674, Niamey

2Bureau de la Représentation de l’OMS au Niger, BP: 10739 Niamey, Niger

3Service Surveillance Épidémiologique et Recherche de l’Hôpital Général de référence de Niamey, BP: 12674, Niamey, Niger

4Departement d’Anesthésie réanimation et Urgences de l’Hôpital Général de référence de Niamey, BP: 12674, Niamey, Niger

5Direction des Études et la programmation; Ministère de la santé Publique, Niamey, Niger

6 Service de Médecine Interne Hôpital Général de référence de Niamey, BP: 12674, Niamey

7University of Nigeria, Nsukka, Enugu State, Nigeria

8Bureau Régional de l’OMS pour l’Afrique, PO Box 06, Brazzaville, Congo

The COVID-19 infection has highlighted the most vulnerable patients. Indeed, COVID-19 patients suffering from another pathology including NCDs such as Arterial Hypertension (Hypertension), diabetes, cancers and respiratory diseases are paying a heavy price for this pandemic. We undertook a study in Niger to better document this comorbidity in a cross-sectional study that brought together patients hospitalized at the Niamey General Reference Hospital for COVID-19 infection and suffering from one or more NCDs. Among 273 patients hospitalized from March 19 to June 03, 2020, 34.8% had a non-communicable disease associated with COVID-19. The average age of the patients was 55 years (22 years to 94 years) and the sex ratio was 2.64 (72.5 % men and 27.5% women). Hypertension was the most represented NCD with 24.5%, followed by diabetes in 17.9% of cases, respiratory diseases 3.66% and other diseases (Heart disease, Obesity, Dyslipidemia, Gout, Chronic renal failure) with 3%. Health workers were the most affected by the disease with 38.6% of cases. The average consultation time was 3.77 days with extremes ranging from 1 to 8 days. The clinical symptoms characterizing the two main groups of patients (hypertensive and diabetic) were almost identical. It consisted mainly of cough, fever, chills, sore throat and rhinorrhea. According to the WHO clinical criteria for the severity of COVID-19, 34 patients or 16.11% were severe and 177 patients or 83% moderate. The clinical severity of the disease is significantly correlated with the patient's age (over 50 years) and the presence of an NCD associated with COVID-19. A total of 35.8% were hospitalized in intensive care in the NCD and COVID-19 group and 14.6% in the NCD group (p <0.001). The average length of patient hospitalization was 6.87 days overall, it was 7 days in intensive care. In 61.7% of cases the length of hospitalization was greater than 4 days. There was 22.1% in the NCD group and 7.3% in the just COVID-19 group (p <0.001). A total of 90.6% of registered deaths occurred in intensive care.

DOI: 10.29245/2689-9981/2021/1.1165 View / Download Pdf