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Spontaneous Bacterial Peritonitis and Short-Term Prognosis in a Group of Decompensated Cirrhotic Patients in Yaounde: A Cross-Sectional Study

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Open Journal of Gastroenterology 2020年第8期10卷 203-213页

作者： Mathurin Pierre Kowo Sylvain Raoul Simeni Njonnou Nelly Karelle Weyou Noubissi Firmin Ankouane Andoulo Gabin Ulrich Kenfack larissa pessidjo djomatcho Hortense Gonsu Kamga Bernadette Ngo Nonga Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Yaounde University Teaching Hospital Yaounde Cameroon Department of Internal Medicine and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Higher Institute of Medical Technology Yaounde Cameroon Department of Microbiology Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Department of Surgery Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Introduction: Spontaneous bacterial peritonitis (SBP) is among the most common infections in cirrhotic patients. Data on SBP are rare in Cameroon. This prompted us to carry out this study on patients with decompensated cirrhosis of the liver in Yaounde University Hospital Centre (YUHC). Methods: We carried out a cross-sectional study from December 2015 to June 2016 in three units of YUHC. All patients with decompensated liver cirrhosis were included. Our sampling was consecutive. Diagnosis of cirrhosis was performed, based on clinical, biological and ultrasound criteria. A neutrophil count greater than 250 cell/mm3 in ascites fluid defined an SBP. Data on socio-demography, clinical presentation, and outcomes were collected. Results: We included 34 decompensated cirrhotic patients (15 males). Patients mean age was 57.5 ± 2 years (SBP positive: 48.7 ± 21.3 versus without SBP: 59.8 ± 19.5, p = 0.22). SBP diagnosis was made in 6 (17.7%) patients. Compared to patients with decompensated liver cirrhosis and without SBP, positive SBP patients had a higher pulse rate (p = 0.002) and respiratory rate (p = 0.02). The patients with SBP were more likely to present these other clinical features: pulse rate >100 (RR: 4.2, [95% CI: 0.7

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Clinical Aspects and Precipitating Factors of Hepatic Encephalopathy Associated with Cirrhosis in a Cameroonian Population

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Open Journal of Gastroenterology 2019年第11期9卷 228-238页

作者： Mathurin Pierre Kowo Edgar Kenne Yimagou Firmin Ankouane Andoulo Antonin Wilson Ndjitoyap Ndam Bonaventure Jemea Servais Albert Fiacre Eloumou Bagnaka Patricia Ouamba Guekam larissa pessidjo Eric Tchoumi Leuwat Dominique Noah Noah Oudou Njoya Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Research Laboratory on Viral Hepatitis and Health Communication Yaoundé Cameroon Internal Medicine Unit Yaounde University Teaching Hospital Yaoundé Cameroon Gastroenterology Unit Central Hospital Yaoundé Cameroon Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroon

Background: Hepatic Encephalopathy (HE), a common complication of cirrhosis, is associated with a pejorative prognosis. This study aims to describe the clinical presentation, precipitating factors and outcome of HE. Methods: This was a cross-sectional multicenter inpatient study in cirrhotic patients admitted for HE in four tertiary hospitals in Yaoundé (Cameroon) from December 2016 to May 2017. The diagnosis of HE was based on West Haven clinical criteria. The diagnosis of cirrhosis was made using clinical and/or biological, endoscopic and/or ultrasonography signs. Results: A total of 53 patients with HE (mean age: 49.9 ± 18.9 years, 35 Males) were included. The frequency of hospital admission for HE was 4.9%. HE grade III was the most common (37.7%), followed by grades I and II (26.4% and 26.4%, respectively). Grade IV was present in 9.4% of cases. According to the Child-Pugh score, 72.1% of the patients were at stage C and 27.9% at stage B. The main precipitating factors found were: constipation (38.5%), hyponatremia (35.9%), hepatocellular carcinoma (HCC) (31.7%), herbal medicine (28.3%), hypokalemia (25.6%), gastrointestinal bleeding (22.6%) and ascitic fluid infection (spontaneous bacterial peritonitis) (13.8%). In 5.7% of cases, no factor was identified. Mortality rate during hospitalization was 45.3% and was significantly associated with stage III (RR = 11.1;95% CI: 1.9 - 64.5;p = 0.003) and IV (RR = 24;95% CI: 1.6 - 40.9;p = 0.01) of HE;Child-Pugh C score (RR = 15.2;95% CI: 1.7 - 30.1;p = 0.003) and hypokalemia (RR = 12.2;95% CI: 1.3 - 19;p = 0.01). Conclusion: HE is a common complication during cirrhosis with a poor prognosis. In the majority of cases, a precipitating factor could be determined.

关键词： Hepatic Encephalopathy Liver Cirrhosis West Haven Criteria Child-Pugh Cameroon

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