Causes and factors of death in the Pulmonology Department in Abidjan

Abstract

Respiratory diseases constitute a major cause of morbidity and mortality worldwide. The objective of our study was to identify the causes and factors associated with the death of patients in the Pulmonology Department of the Treichville University Hospital. This was a retrospective cross-sectional study analyzing patients who died while hospitalized in the Pneumology Department of Treichville University Hospital between April 2019 and April 2020. The study covered 514 files, including 177 deaths, representing an overall mortality of 34.4%. There were 109 men and 68 women with an average age of 45.20 years. The main antecedents were HIV infection (42.18%) and tuberculosis (38.1%). The main causes of death were pulmonary tuberculosis (49.69%), pneumocystosis (20.75%), and bacterial pneumonia (18.87%). Severe anemia (53.68%) and severe renal failure (19.85%) were the biological abnormalities associated with pulmonary pathologies. In univariate analysis, the factors associated with deaths were age less than 25 years, HIV seropositivity, nonmedical access to the service, self-medication, the presence of signs of initial clinical and radiological severity, a diagnosis of tuberculosis and neoplastic pathology, also the existence of difficulties during hospitalization. Multivariate analysis revealed HIV infection [odds ratio (OR)=1.46, confidence interval (CI)=0.27–0.77, P=0.003], diagnosed pulmonary tuberculosis (OR=1.51, CI=0.30–0.87, P=0.01), the presence of signs of clinical severity (OR=1.20, CI=0.09–0.42, P=0.00) and initial radiological severity (OR=1.27, CI=0.11–0.64, P=0.003) and the presence of difficulties during hospitalization (OR=1.16, CI=0.05–0.54, P=0.003). Mortality remains high in pulmonology hospitalizations. Currently, tuberculosis and HIV infection are the main causes of death. Efforts to combat these two conditions must be strengthened by taking into account these factors associated with deaths.