Etiology, Prediction, and Frequency of Hemorrhagic Shock in the Intensive Care Unit

Introduction: Acute hemorrhage remains a major cause of mortality, particularly in trauma, postpartum, anesthesia, and intensive care. In Africa, data are limited, especially outside the obstetric context. The absence of a national algorithm justifies this study, which aims to evaluate the prevalence, etiology, and prognosis of hemorrhagic shock at the Angré University Hospital. Methodology: This is a cross-sectional analytical study conducted from January 2020 to December 2021 at Angré University Hospital, including all patients admitted to intensive care for hemorrhagic shock. Results: Of the 457 patients admitted to intensive care during the study period, 100 had hemorrhage, including 72 cases of hemorrhagic shock. The mean age was 34.31 ± 14.5 years. The male-to-female ratio was 0.18. The majority of patients came from the operating room (79.2%) and 15.3% had sickle cell disease. Hemodynamic instability, particularly hypotension (72.2%), was the main reason for admission. Surgical conditions accounted for 94.4%, and approximately 75% were transferred from another department. The mean systolic blood pressure was 80.37 ± 16.01 mmHg, and the mean diastolic blood pressure was 47.87 ± 11.44 mmHg. The mean heart rate was 118.83 ± 27.04 bpm, with a mean shock index of 1.4. A Glasgow score ≤ 8 (35%) was noted. Biological abnormalities included hyperlactatemia (69.4%), low PT (40.6%), acidosis (38.8%), and hemoglobin < 9 g/dL (84.7%). Mortality was 47.2%, associated with several significant clinical and biological parameters (p < 0.05). Conclusion: Hemorrhagic shock, which is common in intensive care, affects a young, predominantly female population with high mortality, requiring early and multidisciplinary standardization of care.