Analysis of Early Deaths among HIV Patients Admitted to the Medical Emergency Department of CHU Treichville in Abidjan (Côte d'Ivoire)

Introduction: The occurrence of deaths among HIV-positive patients in the Medical Emergency Services (MES) is frequent but has been poorly studied in Côte d’Ivoire. This study aimed to determine the mortality rate among HIV patients and identify factors associated with early deaths of patients admitted to emergency services. Materials and Methods: This was a retrospective cohort study conducted from March 1, 2022, to February 29, 2023 (a 1-year period) at the MES of Treichville. Included in the study were patients admitted for HIV-related complications and those newly diagnosed with HIV at MES. Excluded were HIV-positive patients who died upon arrival (arrival time < 1 hour). The parameters studied included reasons for admission, sociodemographic variables (age, sex, HIV status), clinical variables (medical conditions, clinical stage according to WHO 2007, CD4 count), and the mortality rate. Data analysis was performed using Epi Info software. Results: Among 4,036 admissions to MES, 221 patients (prevalence 5.48%) were HIV-positive. The mean age was 35 (±0.9) years, with a sex ratio of 0.75 and an age range of 16 to 78 years. There was a predominance of females (n=126). Patients already diagnosed as HIV-positive prior to admission accounted for 79.60% of the sample, among whom 60.80% were non-adherent to antiretroviral treatment. The most common reasons for admission were altered consciousness (45.7%), respiratory distress (24.4%), and diarrhea (11.8%). Cerebral toxoplasmosis (26.7%) and pulmonary tuberculosis (15.8%) were the most frequently diagnosed conditions. Patients with CD4 counts < 200 (OR= 0.4003; CI= 0.1875-0.8135, p=0.007706) and WHO stage > 2 (OR= 0.38; CI= 0.1934-0.7611, p=0.0036) had poorer outcomes. The mortality rate was 26.7%. Conclusion: Early deaths occurred predominantly among young adults. The mortality rate was high, underscoring the need to establish voluntary testing centers nationwide and provide support for people living with HIV. Decrease