Usefulness of the Surgical Apgar Score to Predict the Occurrence of Major Complications in the Early Post-Operative Period of Major Surgeries: Experience of Two Second-Category Hospitals in Cameroon

Objective: The Surgical Apgar Score (SAS) is a tool for intraoperative stratification of the risk of serious complications in the early postoperative period. It varies from 0 to 10 points divided into three risk categories (0 to 4 high, 5 to 7 moderate, 8 to 10 low). The aim of the study was to evaluate its relevance in predicting the appearance of these complications. Material and methods: This descriptive and analytical study was carried out at the “Laquintinie” Hospital in Douala and at the Central Hospital in Yaounde, Cameroon. The main data were collected on a population of patients over 18 years old and recorded on a survey form. They consisted of variables of main interest and exposure variables. Univariate and multivariate statistical analysis using top-down logistic regression models made it possible to evaluate the association of each variable of main interest and each exposure variable. The association was significant at P Results: Of the 88 patients studied, the SAS was 3 hours. In multivariate, this link persisted only and strongly for the SAS OR (IC) 0.1 (0.1 - 0.2) and p = 000. Conclusion: The study found a specific and powerful link between the SAS score < 4 and the occurrence of complications in the early postoperative period, in favor of its relevance in predicting them.

Impact of the COVID-19 Pandemic on Patient Attendance and Trends in the Use of Medical Imaging Modalities in a Referral Hospital in the City of Douala, Cameroon

Introduction: The COVID-19 pandemic has led to a massive influx of patients with suspected or confirmed flu to hospitals, paradoxically leading to a decrease in the attendance for some services. This study aspired to assess the impact of the COVID-19 pandemic on the attendance of patients at the Radiology and Medical Imaging Department of a tertiary hospital in Douala, Cameroon. Materials and Methods: This was an observational, retrospective and descriptive hospital-based study. Data on patient attendance was extracted from the medical records at the Radiology Unit of Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) between the 1st of March 2019 and the 30th of August 2021. Results: There was a drop in the number of sonographies and conventional radiographies by 25.73% and 18.26% respectively during the peaks pandemic period of 2020 compared to the preceding pre-pandemic era (2019). There was a recovery in 2021 as the numbers increased. Computed tomography studies increased by 40.65% during the peak pandemic period of 2020. Conclusion: This study enables us to understand the health-seeking behavior during the COVID-19 pandemic. The increase in CT utilization during the peak period of the pandemic nevertheless required caution in order to ensure safety and to promote rational cost-effective utilization.

Comparison of Chest Computed Tomography Findings between Pregnant and Non-Pregnant Women with COVID-19 Infection in Douala Gyneco-Obstetric and Pediatric Hospital, Cameroon

Introduction: Pregnancy is a physiologic state associated with decreased immunity, and the use of medical imaging modalities with ionizing radiation must be justified as potential benefits must outweigh the risk of any harm. However, in the wake of SARS-CoV-2 virus pandemic, chest computed tomography (CT) is necessary to assess the severity of the disease. The objective of this study was to compare the chest CT findings of pregnant and non-pregnant women with SARS-CoV-2 viral pneumonia at a tertiary hospital setting. Materials and Methods: This was a cross-sectional, retrospective, descriptive study of admission records of pregnant and non-pregnant patients aged 15 - 49 years during a three (3) months period (April-July 2020) in DGOPH. Logistic regression was used to search for predictors of lung involvement during COVID-19. Results: A total of 31 patient files were studied of which 9 (29%) were those of pregnant women. The pregnant women mostly had a combination of lung ground-glass opacities and consolidation on CT compared to the non-pregnant women (7 out of 9 cases, 77.8%, vs. 6 out of 22 cases, 22.7%;p = 0.01). The group of pregnant women had more than 3 affected lobes (50.0% vs. 22.7%, p = 0.04) with a middle lobe predilection (77.8% vs. 31.8%, p = 0.02). CT predictors of COVID-19 pneumonia in the group of pregnant women after the multivariable logistic regression analysis were the presence of nodules (aOR = 13.9;95% CI: 1.25 - 134.2;p = 0.032) and linear bands of interlobular septal thickening (aOR = 17.8;95% CI: 1.46 - 217.6;p = 0.024). Conclusion: In this study, the chest CT of pregnant women with COVID-19 pneumonia revealed mostly a combination of findings compared to non-pregnant women, with more affected lobes. These findings suggest the likelihood of a greater CT severity of COVID-19 pneumonia among pregnant women and therefore the need for timely and appropriate management.