EPIDEMIOLOGY OF CARDIOVASCULAR MORTALITY IN PATIENTS UNDER 60 YEARS IN A CARDIOLOGY DEPARTMENT: A STUDY OF 73 CASES IN DAKAR, SENEGAL.

Abstract

Introduction: In-hospital mortality is a critical indicator of healthcare quality, although most hospital deaths result from unavoidable morbid processes.

Objectives: This study aimed to examine cardiovascular mortality in working-age patients by analysing epidemiological, clinical, and paraclinical characteristics and identifying the key etiological factors associated with mortality.

Methodology: A descriptive and analytical retrospective study was conducted from September 2019 to August 2022 at the General Hospital Idrissa POUYE in Dakar. The study focused on patients aged 15 to 60 years who were hospitalised and subsequently died in the cardiology department. Bivariate analysis was used, with a p-value ≤ 0.05 considered statistically significant.

Results: A total of 73 patients were included, revealing a specific mortality rate of 8.8%. The majority of patients were male (sex ratio 1.2) with an average age of 44. The main cardiovascular risk factors identified were sedentarism (76.7%), hypertension (28.8%), and smoking (21.9%). Physical examinations showed signs of heart failure in 63%, while diagnostic tests revealed anemia (59%) and renal impairment (25%). Echocardiographic findings indicated impaired left ventricular ejection fraction (81%), pulmonary hypertension (78%), and kinetic abnormalities (40%). Cardiogenic shock (45.2%) and septic shock (37%) were the primary immediate causes of death. The analysis revealed significant associations between mortality and factors such as age, socio-economic status, ischaemic heart disease (p=0.034), pulmonary embolism (p=0.034), hypertension (p=0.009), smoking (p=0.011), diabetes (p=0.011), dyslipidaemia, obesity (p=0.001), and COVID-19 infection (p=0.017).

Conclusion: The high prevalence of ischaemic heart disease and pulmonary embolism in premature mortality highlights the need for intensified cardiovascular prevention measures. Keywords: Cardiovascular mortality, under 60 years, Dakar, Senegal.