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Tanzania Journal of Health Research
Health User's Trust Fund (HRUTF)
ISSN: 1821-6404
Vol. 15, No. 4, 2013, pp. 1-8
Bioline Code: th13030
Full paper language: English
Document type: Research Article
Document available free of charge

Tanzania Journal of Health Research, Vol. 15, No. 4, 2013, pp. 1-8

 en Predictors of Outcome among patients with Obstructive jaundice at Bugando Medical Centre in north-western Tanzania
MABULA, JOSEPH B.; GILYOMA, JAPHET M.; MCHEMBE, MABULA D.; JAKA, HYASINTA; KAMUGISHA, ERASMUS; KIDENYA, BENSON; RAMBAU, PETER F. & CHALYA, PHILLIPO L.

Abstract

Despite recent advances both in preoperative diagnosis and postoperative care, obstructive jaundice still contributes significantly to high morbidity and mortality. A prospective study was undertaken to identify predictors of outcome among patients with obstructive jaundice at Bugando Medical Centre in north-western Tanzania. A total of 138 patients were studied. The male to female ratio was 1:1.6. The median age of patients was 58 years. Patients with malignant obstructive jaundice were older than those of benign type (P < 0.001). Ca head of pancreas (65.1%) was the commonest malignant cause of jaundice where as choledocholithiasis (51.9%) was the commonest benign cause. Twelve (9.7%) patients were HIV positive with a median CD 4+ count of 342 cells/μl. A total of 130 (94.2%) patients underwent surgical treatment and the remaining 8 (5.8%) patients were unfit for surgery. The complication rate was 30.4% mainly due to surgical site infections and it was significantly influenced by malignant causes, WBC count > 10 X 109/l and HIV infection with low CD4 (≤ 200 cells/μl) (p < 0.0001). The median hospital stay and mortality rate were 18 days and 20.3%, respectively. A low haematocrit and presence of postoperative complications were the main predictors of the hospital stay (P < 0.001), whereas age > 60 years, prolonged duration of jaundice, malignant causes, high bilirubin levels, HIV infection with low CD4+ count (≤ 200 cells/μl) and presence of postoperative complications significantly predicted mortality (P< 0.001). In conclusion, our study highlighted the important factors that predict the outcome of patients presenting with obstructive jaundice at BMC; therefore attention should be focused to these factors so as to improve the outcome of these patients.

Keywords
Obstructive jaundice; predictors; outcome; Tanzania

 
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