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ABSTRACT
Background. The number of patients on dialysis is increasing in Cameroon as a result of the multiplication of dialysis centres and the availability of nephrologists. However significant challenges remain as pertains to delivery of optimal haemodialysis, in part, due to precarious socioeconomic conditions and frequent hospitalizations. Causes of admission have not been identified in our setting. Objective. To determine the frequency, causes, predictors and outcome of hospitalizations amongst chronic haemodialysis patients at the Buea Regional Hospital (BRH). Methods. We conducted a 5-year retrospective study at the medical ward of the BRH. We included the files of all patients on maintenance haemodialysis (HD) admitted during the time frame and excluded the files of patients with an HD vintage of <3 months. We recorded the socio-demographic data, dialysis parameters, and data of admissions (number of admissions, diagnosis, survival and duration). Data was analysed using statistical package for social sciences version 26. Statistical significance was set at a p-value <0.05. Results. A total of 87 patients where admitted for a cumulative total of 201 admissions in five years, giving an average frequency of 2.3 admissions per patient per year. Non adherence to haemodialysis (p=0.01, OR=1.13, 95% CI: 1.03 - 1.70) was a predictor of frequent hospitalizations. Infections (39.13%), anaemia (34.78%), and fluid overload (17.93%) were the most frequent causes of admission. The median hospital stay was 6 (1-20) days and patients with a central venous catheter (p<0.01, OR=1.5, 95% CI: 1.2 - 2.0), and those not adherent to haemodialysis (p<0.01, OR=1.7, 95% CI: 1.3 - 2.3) had an approximately doubled risk of prolonged hospital stay. Conclusion. The proportion of chronic HD patients hospitalized at the BRH is high. These patients are admitted for preventable causes, mainly anaemia, sepsis and infections.
RÉSUMÉ
Introduction et objectif. Le fardeau de l'hospitalisation sur la population dialysée est très important par ce que ils sont associé à des résultats cliniques mortels et ont de coûts de santé très élevés. L’objectif du travail était de déterminer la fréquence et les facteurs prédictifs des hospitalisations fréquentes, évaluer l'issue des hospitalisations, chez les patients hémodialysés chroniques à l'Hôpital Régional de Buea (HRB) en 5 ans. Méthodes. Nous avons mené une étude rétrospective sur 5 ans (Janvier 2016 à Décembre 2021) à l'unité de médecine interne de l’HRB. Nous avons inclus les dossiers de tous les patients en dialyse d'entretien en hémodialyse (HD) et exclu les dossiers des patients de moins de 3 mois en HD. Les données sociodémographiques, les paramètres de dialyse et les données d'admissions (nombre d'admissions, causes, survie et durée) ont été enregistrées. Résultats. Au total, 87 des 112 patients ont eu 201 admissions en cinq ans, avec une fréquence moyenne de 2,3 admissions par patient. La non-adhésion à l'hémodialyse (p=0.01, OR=1.13) était un facteur prédictif d'hospitalisations fréquentes. Les infections (39,13 %), l'anémie (34,78 %) et la surcharge liquidienne (17,93 %) étaient les causes les plus fréquentes d'admission. La septicémie au cathéter (14,13 %) et le paludisme (12,5 %) étaient les causes les plus courantes d'hospitalisations liées à une infection. Parmi les 87 patients, 13 patients (14,9%) sont décédés à l'admission, et les principales causes de décès étaient l'anémie sévère (46,15%) et le sepsis sévère (30,77%). La néphropathie diabétique un déterminant de la mortalité (p=0.039, OR=1.66). La durée médiane d'hospitalisation était de 6(1-20) jours et les patients porteurs d'un cathéter veineux central (p<0.01, OR=1.5) et ceux qui n'adhèrent pas (p<0.01, OR=1.7) à l'hémodialyse présentaient un risque approximativement doublé de séjour prolongé à l'hôpital. Conclusion. La fréquence d'hospitalisation des patients HD chroniques à l’HRB est élevée. Ces patients meurent de causes évitables, généralement une anémie sévère et une septicémie.

Keywords

hospitalisation causes outcomes hemodialysis buea regional hospital hospitalisation causes devenir hemodialyse hopital regional de buea

Article Details

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Author Biographies

Denis Georges Teuwafeu , Faculty of Health Sciences, University of Buea

Lecturer

Clovis Nkoke

Assistant Lecturer

Cyrille Nkouonlack

Lecturer

Divine Mokake

lecturer

Vincent Verla

associate professor 

Marie-Patrice Halle

associate Professor

How to Cite
Teuwafeu , D. G. ., Gobina , R. ., Pouekoua , B. C. M. ., Nkoke, C. . ., Nkouonlack, C. ., Mokake, D. ., Verla, V., & Halle , M.-P. . (2022). Causes and Outcome of Hospitalizations amongst Chronic Haemodialysis Patients at the Buea Regional Hospital. HEALTH SCIENCES AND DISEASE, 23(10). https://doi.org/10.5281/hsd.v23i10.3892
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