Saudi Journal of Medicine & Medical Sciences最新文献

{"title":"Utility of the Xpert Xpress CoV-2/Flu/RSV Plus Kit: A Glance at RSV Infection in Adults and Coinfection Rate.","authors":"Khaled R Alkharsah","doi":"10.4103/sjmms.sjmms_376_23","DOIUrl":"10.4103/sjmms.sjmms_376_23","url":null,"abstract":"<p><strong>Background: </strong>Viral infection is responsible for the majority of respiratory tract infections (RTI). This retrospective study evaluates the advantages of using the multiplex Xpert Xpress CoV-2/Flu/RSV plus kit in laboratory diagnosis of RTI caused by the most related viruses.</p><p><strong>Materials and methods: </strong>Data were obtained from medical records between November 2021 and May 2023 for any sample tested using either the Xpert Xpress Flu/RSV kit, Xpert Xpress Flu kit, Xpert Xpress SARS-CoV-2 kit, and Xpert Xpress CoV-2/Flu/RSV plus kit.</p><p><strong>Results: </strong>Influenza virus A was detected in 8.5% (55/649) of the samples using the Flu PCR kit and in 4.9% (123/2538) using CoV-2/Flu/RSV plus kit, while influenza virus B detection rates were 3.7% (24/649) using the Flu PCR kit and 1.7% (43/2538) using the CoV-2/Flu/RSV plus kit. However, the detection rates using the two kits were comparable when evaluated for the same time period of the year. SARS-CoV-2 infections were detected in 16.9% (1545/9153) and 10.5% (266/2538) of the cases using the SARS-CoV-2 kit and CoV-2/Flu/RSV plus kits, respectively. Respiratory syncytial virus (RSV) was identified in 17.7% (66/372) of children using Flu/RSV kit; this number dropped significantly when age-targeted testing of RSV was performed due to involvements of adults. With the CoV-2/Flu/RSV plus kit, about 34% (35/103) of RSV infections detected were in patients aged >20 years; these cases would have previously been overlooked because adults are not routinely tested for RSV using the Flu/RSV kit. All coinfection cases (<i>n</i> = 16) were only detected with the CoV-2/Flu/RSV plus kit.</p><p><strong>Conclusion: </strong>The use of Xpert Xpress CoV-2/Flu/RSV plus kit not only results in shorter turnaround times through accurate detection of all four viruses, but also provides information on RSV infection in adults and coinfection rates.</p>","PeriodicalId":21442,"journal":{"name":"Saudi Journal of Medicine & Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Sequence Intubation in Children, Why Not?","authors":"Ramón Eizaga Rebollar, Paula Lozano Hierro, Ana Mercedes Martínez-Almendros Fernández","doi":"10.4103/sjmms.sjmms_612_23","DOIUrl":"10.4103/sjmms.sjmms_612_23","url":null,"abstract":"<p><p>Tracheal intubation in pediatric patients is a clinical scenario that can quickly become an emergency. Complication rates can potentially reach up to 60% in rapid sequence intubation. An alternate to this is delayed sequence intubation, which may reduce potential complications-mostly hypoxemia-and can be especially useful in non-cooperative children. This technique consists of the prior airway and oxygenation optimization. This is done through sedation using agents that preserve ventilatory function and protective reflexes and continuous oxygen therapy-prior and after the anesthetic induction-using nasal prongs. The objective of this narrative review is to provide a broader perspective on delayed sequence intubation by defining the concept and indications; reviewing its safety, effectiveness, and complications; and describing the anesthetic agents and oxygen therapy techniques used in this procedure.</p>","PeriodicalId":21442,"journal":{"name":"Saudi Journal of Medicine & Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Privatization on Healthcare System: A Systematic Review.","authors":"Tareq M Alayed, Assem S Alrumeh, Ibrahim A Alkanhal, Raghad T Alhuthil","doi":"10.4103/sjmms.sjmms_510_23","DOIUrl":"10.4103/sjmms.sjmms_510_23","url":null,"abstract":"<p><strong>Background: </strong>A notable shift in healthcare policy is healthcare privatization, which refers to the transfer of ownership, management, or provision of healthcare services from the public sector to private entities.</p><p><strong>Objectives: </strong>To provide a narrative examination of the impact of privatization on various dimensions of healthcare, including quality, equity, accessibility, and cost-effectiveness. Policymakers can utilize the findings of this study to make well-informed decisions regarding privatization strategies.</p><p><strong>Materials and methods: </strong>A systematic review was implemented using the following databases: PubMed, Scopus, and Google Scholar. Studies conducted from January 2000 to January 2023 in developing or developed countries that assessed the impact of healthcare privatization on population health within public sector institutions were included.</p><p><strong>Results: </strong>Eleven studies were included. The findings revealed diverse perspectives on the impact of healthcare privatization, with four studies (36.4%) supporting privatization (two of these were conducted in Saudi Arabia), six studies (54.5%) opposing it (three of these were conducted in European countries), and one study (9.1%) taking a neutral stance. Two studies investigated the impact on healthcare quality, and both revealed that privatization negatively impacts uninsured patients and low-income populations. In addition, five studies investigated the healthcare access and equity dimensions following privatization: one was in favor, one was neutral, and three were opposing it. Four studies investigated the cost-effectiveness dimension, with three in favor and one study opposing it.</p><p><strong>Conclusion: </strong>This review highlights different perspectives on healthcare privatization. While studies, as those from Saudi Arabia, suggest benefits in terms of efficiency and innovation, others, particularly from European countries, emphasize negative consequences such as inequity and reduced quality. This emphasizes the need for more investigations to understand privatization's impact on healthcare.</p>","PeriodicalId":21442,"journal":{"name":"Saudi Journal of Medicine & Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Classical Extraintestinal Manifestations among Inflammatory Bowel Disease Patients in Saudi Arabia: A Single Tertiary Center Experience.","authors":"Abdullah Alotaibi, Abrar Alhubayshi, Abed Allehibi, Abdullah Almtawa, Nawaf Alotaibi, Adel Alghamdi, Saad Alrajhi, Adel Alqutub, Ahmad Aleid, Abdulrhman Alamr, Bashaar Ibrahim, Mohammed Alahmari, Hussam Alhamidi, Shameem Ahmad, Hadeel AlBayyat, Osama Alshaya, Youssef Altannir, Ahmed Alghamdi","doi":"10.4103/sjmms.sjmms_139_23","DOIUrl":"10.4103/sjmms.sjmms_139_23","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel disease (IBD) may also experience extraintestinal manifestations (EIMs), which can affect various organ systems, and their occurrence is based on disease activity.</p><p><strong>Objectives: </strong>To determine the prevalence of EIMs and their most common types among IBD patients from Saudi Arabia.</p><p><strong>Materials and methods: </strong>This retrospective study included all IBD patients aged 14-80 years who visited the Gastroenterology and Hepatology clinics at King Fahad Medical City, Riyadh, between February 2017 and December 2022. The collected data included demographic characteristics, disease characteristics, EIMs, and treatment.</p><p><strong>Results: </strong>The study included 578 IBD patients, of which 65 (11.2%) had at least one EIM, with primary sclerosing cholangitis (46.2%) and sacroiliitis (16.9%) being the most common. Patients with ulcerative colitis were more likely to have EIMs than those with Crohn's disease (15.1% vs. 9%; <i>P</i> = 0.026). Patients with ileocolonic (L3) Crohn's disease reported a higher prevalence of EIMs (7.5%) than those with other disease locations (<i>P</i> = 0.012), while in patients with ulcerative colitis, those with extensive colitis (E3) reported higher prevalence of EIMs (19.2%) (<i>P</i> = 0.001). Patients receiving 6 MP had a significantly high prevalence of EIMs (<i>P</i> = 0.014).</p><p><strong>Conclusion: </strong>The prevalence of extraintestinal manifestations among IBD patients in Saudi Arabia is 11.2%. These findings suggest the need for clinicians to screen for EIMs and manage them early. Further research is needed to understand the mechanisms underlying EIMs for the development of more effective treatments.</p>","PeriodicalId":21442,"journal":{"name":"Saudi Journal of Medicine & Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Child Safety Seat and its Determinants in Jeddah, Saudi Arabia: A Cross-sectional Study.","authors":"Heidi Kamal Al-Wassia, Omar K Bokhari, Mohammed A Aljahdali, Mohammad An Bawazier, Mohammad Ab Basheikh, Mansour A Alsheekh, Yazeed T Alandunesi, Mohammad N Hakeem, Maha Y Bamehrez, Dalia E Meisha","doi":"10.4103/sjmms.sjmms_330_23","DOIUrl":"10.4103/sjmms.sjmms_330_23","url":null,"abstract":"<p><strong>Background: </strong>A child safety seat protects children from injury during motor vehicle accidents (MVAs). However, there is a lack of enforcement of regulation regarding its use in Saudi Arabia.</p><p><strong>Objectives: </strong>This study aimed to determine the use of child safety seat and its determinants and barriers in Jeddah, Saudi Arabia.</p><p><strong>Materials and methods: </strong>This cross-sectional study was based on a structured face-to-face interview across Jeddah among families who drove in cars with children aged ≤5 years. The study used stratified multistage random sampling across the population of the governorate of Jeddah.</p><p><strong>Results: </strong>A total of 675 parents were included, of which 311 (46.1%) reported having a child safety seat in their vehicle, and only 165 (24.4%) reported its regular use. Awareness levels among parents regarding child safety seat use and its benefits, parents' level of education, family size, family income, and the belief in the need for laws governing child safety seat were key determinants of child safety seat use. Poor awareness among parents regarding the utility of child safety seat in reducing child injuries, low education levels among parents, larger families with multiple children, poor affordability, low family income, and a clear lack of laws mandating the use of child safety seat were identified as key barriers.</p><p><strong>Conclusions: </strong>The regular use of child safety seat for children aged ≤5 years is low in even one of the most urban populations of Saudi Arabia. This indicates the need for large-scale awareness drives and stricter implementation of laws enforcing the use of child safety seat in Saudi Arabia.</p>","PeriodicalId":21442,"journal":{"name":"Saudi Journal of Medicine & Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Coronary Artery Dissection Associated with Pulmonary Hemorrhage: A Case Report.","authors":"Rudaynah A Alali","doi":"10.4103/sjmms.sjmms_471_23","DOIUrl":"10.4103/sjmms.sjmms_471_23","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection is becoming an important cause of acute coronary syndrome, particularly among young women. Its association with female gender, pregnancy, and postpartum period and emotional stress differentiate it from atherosclerotic heart disease. In recent years, there has been more awareness and improved diagnostic and management capabilities, which in turn has increased the diagnostic yield, although knowledge gaps remain. In the present case, a 36-year-old female, who was at 1-month postpartum period, presented with ventricular fibrillation and cardiac arrest. The clinical course was associated with pulmonary hemorrhage. The patient had no current atherosclerotic risk factors, only a family history of sudden cardiac arrest in her mother and sister. She underwent a coronary angiogram, which revealed spontaneous coronary artery dissection (SCAD) in both the left anterior descending and left circumflex artery. Percutaneous coronary intervention was performed but the clinical course was associated with pulmonary hemorrhage. Bronchopulmonary lavage was performed as a diagnostic and therapeutic intervention, and she was discharged in good health. SCAD is an important differential diagnosis in young females presenting with acute coronary syndrome or cardiac arrest. Early recognition and diagnosis are important to decrease the high mortality rate of this disease.</p>","PeriodicalId":21442,"journal":{"name":"Saudi Journal of Medicine & Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unplanned Readmissions in Children with Medical Complexity in Saudi Arabia: A Large Multicenter Study.","authors":"Futoon Alotaibi, Hamad Alkhalaf, Hissah Alshalawi, Hadeel Almijlad, Abdulaziz Ureeg, Suliman Alghnam","doi":"10.4103/sjmms.sjmms_352_23","DOIUrl":"10.4103/sjmms.sjmms_352_23","url":null,"abstract":"<p><strong>Background: </strong>Children with medical complexity (CMC) account for a substantial proportion of healthcare spending, and one-third of their expenditures are due to readmissions. However, knowledge regarding the healthcare-resource utilization and characteristics of CMC in Saudi Arabia is limited.</p><p><strong>Objectives: </strong>To describe hospitalization patterns and characteristics of Saudi CMC with an unplanned 30-day readmission.</p><p><strong>Methodology: </strong>This retrospective study included Saudi CMC (aged 0-14 years) who had an unplanned 30-day readmission at six tertiary centers in Riyadh, Jeddah, Dammam, Alahsa, and Almadina between January 2016 and December 2020. Hospital-based inclusion criteria focused on CMC with multiple complex chronic conditions (CCCs) and technology assistance (TA) device use. CMC were compared across demographics, clinical characteristics, and hospital-resource utilization.</p><p><strong>Results: </strong>A total of 9139 pediatric patients had unplanned 30-day readmission during the study period, of which 680 (7.4%) met the inclusion criteria. Genetic conditions were the most predominant primary pathology (66.3%), with one-third of cases (33.7%) involving the neuromuscular system. During the index admission, pneumonia was the most common diagnosis (33.1%). Approximately 35.1% of the readmissions were after 2 weeks. Pneumonia accounted for 32.5% of the readmissions. After readmission, 16.9% of patients were diagnosed with another CCC or received a new TA device, and the in-hospital mortality rate was 6.6%.</p><p><strong>Conclusion: </strong>The rate of unplanned 30-day readmissions in children with medical complexity in Saudi Arabia is 7.4%, which is lower than those reported from developed countries. Saudi children with CCCs and TA devices were readmitted approximately within similar post-discharge time and showed distinct hospitalization patterns associated with specific diagnoses. To effectively reduce the risk of 30-day readmissions, targeted measures must be introduced both during the hospitalization period and after discharge.</p>","PeriodicalId":21442,"journal":{"name":"Saudi Journal of Medicine & Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rate and Causes of 30-day Unplanned Readmission/Return Following Head and Neck Surgery at a Tertiary Care Center in Saudi Arabia.","authors":"Mazin Merdad, Abdulsalam Alqutub, Ahmed Mogharbel, Abdullah A Alghamdi, Omar Alsulami, Mohammed Awadh, Ahmed S Alsulami","doi":"10.4103/sjmms.sjmms_138_23","DOIUrl":"10.4103/sjmms.sjmms_138_23","url":null,"abstract":"<p><strong>Background: </strong>Identifying and targeting common preventable causes of 30-day hospital readmissions could help improve survival rates and reduce the healthcare burden.</p><p><strong>Objective: </strong>To determine the rate and causes of unplanned hospital return/readmission to the Outpatient Department (OPD) or Emergency Department (ED) within 30 days after discharge following head and neck surgery (HNS) at a tertiary hospital in Western Saudi Arabia.</p><p><strong>Methods: </strong>This retrospective study included all adult patients (aged ≥18 years) who had undergone HNS at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 2015 and December 2022 and returned to the OPD or ED within 30 days of being discharged.</p><p><strong>Results: </strong>Of 1041 patients who had undergone HNS, 84 (8.1%) returned to the hospital within 30 days after discharge: 63 (6.1%) to the OPD and 21 (2.0%) to the ED. A total of 9 (0.9%) patients were readmitted as inpatients, most commonly for infections (33.3%) and neurological symptoms, including weakness and seizures (22.2%). For OPD visits, common causes were wound swelling (25.4%) and neurological symptoms (17.5%). For ED returns, frequent causes were neurological symptoms (23.8%) and surgical site bleeding (19.1%). Readmission was associated with intensive care unit (ICU) admission during the primary hospital stay (<i>P</i> = 0.003) and higher preoperative baseline health burdens when examined using the American Society of Anesthesiology score (<i>P</i> = 0.022), the Cumulative Illness Rating Scale (<i>P</i> = 0.007), and the Charlson Comorbidity Index (CCI) (<i>P</i> = 0.006).</p><p><strong>Conclusion: </strong>The rate of 30-day unplanned hospital return following head and neck surgery was 6.1% and 2.0% through the OPD and the ED, respectively; 0.9% were readmitted as inpatients. Common causes of return included wound swelling, infections, bleeding, and neurological symptoms.</p>","PeriodicalId":21442,"journal":{"name":"Saudi Journal of Medicine & Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality and Readability Assessment of Web-based Arabic Health Information on Early Childhood Caries.","authors":"Shahad S Alkhuwaiter, Fatimah Alssafi, Renad Alshunaiber, Yasser Bin Ahmed, Bayan Albdah","doi":"10.4103/sjmms.sjmms_443_23","DOIUrl":"10.4103/sjmms.sjmms_443_23","url":null,"abstract":"<p><strong>Background: </strong>Patients are increasingly using the internet for searching health-related information. However, the quality and readability of the information available on the internet need to be assessed. To date, no study has assessed the quality and readability of web-based Arabic health information on early childhood caries.</p><p><strong>Objectives: </strong>To evaluate the quality and readability of patient-oriented online Arabic health information regarding early childhood caries.</p><p><strong>Materials and methods: </strong>For this infodemiological study, the Google and Yahoo search engines were searched using specific Arabic terms for early childhood caries, and the top 100 searches from both search engines were considered. Eligible websites were categorized in terms of affiliation as commercial, health portal, dental practice, professional, and journalism. The quality of the websites was assessed using the QUality Evaluation Scoring Tool (QUEST), and readability using the Gunning Fog index (GFI).</p><p><strong>Results: </strong>A total of 140 websites were included after applying the exclusion criteria, of which 50.7% websites were of journalism. The majority of the websites (70%) had an overall low-quality level, with a QUEST score <10. The quality of websites retrieved from Google searches was of significantly higher quality than those from Yahoo (<i>P</i> < 0.0001). More than half (51.4%) of the websites had good readability, with a GFI score ≤8. Journalism websites had a significantly higher proportion of websites with poor readability level (62%) compared with other affiliations (<i>P</i> = 0.0072).</p><p><strong>Conclusion: </strong>The web-based Arabic information regarding early childhood caries is currently of low quality and moderate readability level, thereby indicating a need for improving such patient-facing content.</p>","PeriodicalId":21442,"journal":{"name":"Saudi Journal of Medicine & Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of Cancer Patients with an Unplanned Intensive Care Unit Admission: Predictors of Mortality and Long-term Survival.","authors":"Ghiath AlSaied, Hani Lababidi, Taher AlHawdar, Saud AlZahrani, Abdullah AlMotairi, Mohamad AlMaani","doi":"10.4103/sjmms.sjmms_145_23","DOIUrl":"10.4103/sjmms.sjmms_145_23","url":null,"abstract":"<p><strong>Background: </strong>Understanding the characteristics and outcomes of cancer patients with unplanned ICU admission is imperative for therapeutic decisions and prognostication purposes.</p><p><strong>Objective: </strong>To describe the clinical characteristics of patients with hematological and non-hematological malignancies (NHM) who require unplanned ICU admission and to determine the predictors of mortality and long-term survival.</p><p><strong>Methods: </strong>This retrospective study included all patients with cancer who had an unplanned ICU admission between 2011 and 2016 at a tertiary hospital in Saudi Arabia. The following variables were collected: age, gender, ICU length of stay (LOS), APACHE II score, type of malignancy, febrile neutropenia, source and time of admission, and need for mechanical ventilation (MV), renal replacement therapy (RRT), and treatment with vasopressors (VP). Predictors of mortality and survival rates at 28 days and 3, 6, and 12 months were calculated.</p><p><strong>Results: </strong>The study included 410 cancer patients with 466 unplanned ICU admissions. Of these, 52% had NHM. The average LOS in the ICU was 9.6 days and the mean APACHE score was 21.9. MV was needed in 73% of the patients, RRT in 15%, and VP in 24%, while febrile neutropenia was present in 24%. There were statistically significant differences between survivors and non-survivors in the APACHE II score (17.7 ± 8.0 vs. 25.6 ± 9.2), MV use (52% vs. 92%), need for RRT (6% vs. 23%), VP use (42% vs. 85%), and presence of febrile neutropenia (18% vs. 30%). The predictors of mortality were need for MV (OR = 4.97), VP (OR = 3.43), RRT (OR = 3.31), and APACHE II score (OR = 1.10). Survival rates at 28 days, 3, 6, and 12 months were 52%, 28%, 22%, and 15%, respectively.</p><p><strong>Conclusion: </strong>The survival rate of cancer patients with an unplanned admission to the ICU remains low. Predictors of mortality include need for MV, RRT, and VP and presence of febrile neutropenia. About 85% of cancer patients died within 1 year after ICU admission.</p>","PeriodicalId":21442,"journal":{"name":"Saudi Journal of Medicine & Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}