Mortality in the Emergency Department of the 2 Army Training Hospitals in Gabon: A Retrospective Study

Introduction: Mortality is a frequent phenomenon in the Emergency Department (ED) and a major public health concern. In Gabon, few have examined mortality problems specific to emergencies. The interest of our study is to describe the epidemiological profile of patients who died within 72 hours in the emergency services of the two Military Teaching hospitals in Libreville. Method: This is a bicentric descriptive study retrospectively from May 2018 to April 2019. Results: During the study period, there were 20,339 visits to the ED, including 209 patients who died within 72 hours of admission to the ED. The specific mortality rate of the study’s population was 1.03% of annual passages. The majority of deaths were among men (58.3%). The average age was 46.5 ± 24.6 years. High blood pressure and AIDS were the main medical conditions reported with 23.5% and 17.8% respectively. The majority of patients returned from home (81.9%) and in 94.6% of cases, by cab or personal car. The main chief complaint was altered consciousness (29.5%), most frequently after one week of symptom progression (28.8%). At admission, 64.4% of patients showed signs of neurological distress. The ASAP score was predictive at admission for 27.36% of deceased patients. The death occurred on average after a delay of 19.1 ± 19.9 hours. The majority of patients died within 6 hours and 62.6% of deaths were reported during on-call time. The cause of death was medical in 77% of cases. Some patients presented with multiple pathologies and infectious pathologies were mentioned in 66.46% of the observations, followed by neurological disorders (21.11%). Preliminary cardiopulmonary resuscitation procedures were undertaken for 76.96% of the patients who died. Conclusion: This survey provides an overview of UAS mortality in Libreville’s HIAs and identifies some areas for improvement in our health system.