Comparison of Prognostic Scores for Upper Gastrointestinal Bleeding in the Hepato-Gastro-Enterology Department of Campus Teaching Hospital of Lome

Objective: To evaluate and compare the prognostic contribution of different UGIB prognostic scores. Patients and Method: Descriptive cross-sectional study with retrospective collection conducted from January 2014 to December 2019. Patients hospitalized in the Gastroenterology Department of Campus Teaching Hospital of Lome for upper gastrointestinal hemorrhage were included. The analytical component of this study had consisted of an evaluation of the sensitivity and specificity of different prognostic scores (GBS, mGBS, FRS, CRS, AIMS65) in predicting the occurrence of death and/or re-bleeding within 42 days. These different scores were compared using ROC (Receiver Operating Characteristic) curves. Results: We included 314 patients in our study. The male to female sex ratio was 2.48. Fibroscopy found non-related portal hypertension UGIB in 70.94% of the cases. The “FRS” was the most accurate score in predicting death or re-bleeding in all patients. The “FRS” was the most precise score in predicting the occurrence of spotting in all patients. The “FRS” was the most accurate score in predicting death among all patients. The mortality of patients at low risk of death (below the threshold value) was 2.2% for the “FRS”, 9.3% for the “CRS”, 0% for the “GBS” (p = 0.565), 50% for the “mGBS” and 11.4% for the “AIMS65”. Scores were more accurate for non-related portal hypertension UGIB. Conclusion: The “FRS” and the “CRS” are two precise scores in predicting the occurrence of an incident in the event of upper gastrointestinal hemorrhage. However, these scores were less effective in related portal hypertension UGIB.

Hematological Profile of Anemia in Hospitalized Cirrhotics in the Hepato-Gastroenterology Unit of the University Hospital Campus of Lome (Togo)

Background: Anemia is multifactorial and very frequently observed in the evolution of cirrhosis. Only biological investigations can clarify its mechanisms. Objective: To determine the frequency of anemia in cirrhosis patients and to identify the different types of anemia encountered. Patients and Methods: Descriptive and analytical study based on the retrospective collection of data was carried out over 12 months in the hepato-gastroenterology unit of the University Hospital Campus of Lome (Togo). This study included hospitalized cirrhotic patients with a complete medical file including a blood count and presenting anemia. Results: During the study period, we collected 253 cases of cirrhosis, of which 153 patients had anemia (60.5%);there was a male predominance of 73.2%. The mean age was 51 ± 13 years. The B viral origin of cirrhosis was the most common (60.1%). Oedemato-ascitic decompensation (82.4%) and hepatocellular carcinoma (34%) were the main complications. The Child-Pugh B score was the most represented (74.5%). Hypochromic microcytic anemia was noted (48.4%) followed by normochromic normocytic anemia (46.4%);82 patients (53.6%) had thrombocytopenia;pancytopenia was noted in 17 patients (11.1%). Hepatitis B virus was most commonly found with 50% hypochromic microcytic anemia followed by 46.7% normochromic normocytic anemia (p = 0.311). Hepatic encephalopathy was significantly more frequent in patients with hypochromic microcytic anemia (45.5%) (p = 0.025);hepatocellular carcinoma was significantly noted with 63.5% hypochromic microcytic anemia (p = 0.016). Child-Pugh C score with 47.4% hypochromic microcytic anemia was more frequent (p = 0.673). Conclusion: Hypochromic microcytic anemia was the most common type of anemia noted in our study. Hepatic encephalopathy and hepatocellular carcinoma were the major complications of cirrhosis significantly associated with the hypochromic microcytic anemia.