Saudi Medical Journal最新文献_第7页

COVID-19-Associated Rhabdomyolysis in Hospitalized Patients: Retrospective Cohort Study. 住院患者covid -19相关横纹肌溶解：回顾性队列研究

IF 2.1 4区医学

Saudi Medical Journal Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.15537/1658-3175.8794

Paula Esquerdo-Serrano, Silvia Otero-Rodriguez, Hector Pinargote-Celorio, Sergio Reus, Esperanza Merino, José-Manuel Ramos-Rincón

{"title":"COVID-19-Associated Rhabdomyolysis in Hospitalized Patients: Retrospective Cohort Study.","authors":"Paula Esquerdo-Serrano, Silvia Otero-Rodriguez, Hector Pinargote-Celorio, Sergio Reus, Esperanza Merino, José-Manuel Ramos-Rincón","doi":"10.15537/1658-3175.8794","DOIUrl":"10.15537/1658-3175.8794","url":null,"abstract":"Objectives: To determine the frequency of rhabdomyolysis in patients hospitalized with COVID-19 and to characterize their clinical features and outcomes.Methods: All adults admitted to the hospital were included in this single-center retrospective cohort study with COVID-19 at a tertiary care institution in Alicante, Spain, between March 2020 and March 2024. A creatine kinase (CK) threshold of 1000 U/L or higher was used to define rhabdomyolysis. Demographic, clinical, laboratory, treatment, and outcome data were collected. Patients with and without rhabdomyolysis were compared, and factors associated with in-hospital mortality (IHM) were analyzed.Results: Among 7,590 hospitalized COVID-19 patients, 20 developed rhabdomyolyses (cumulative incidence 0.26%; 95% CI 0.170.41). Most affected patients were male (85%), and male sex demonstrated an independent relationship with rhabdomyolysis (adjusted OR 4.35; 95% CI 1.2714.94). Acute kidney injury was observed in 60% of patients, and 15% required hemodialysis. IHM was markedly higher among patients with rhabdomyolysis than in those without (35% vs. 11.5%) (adjusted OR 4.24; 95% CI 1.4812.10).Conclusion: Rhabdomyolysis was an uncommon but severe complication of COVID-19, predominantly affecting men and frequently inked to acute kidney failure and high IHM.","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 6","pages":"1095-1099"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Early Adversity to Adult Health: Quality-of-Life Consequences in A Mental Illness in Saudi Arabia. 从早期逆境到成年健康：沙特阿拉伯精神疾病的生活质量后果。

IF 2.1 4区医学

Saudi Medical Journal Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.15537/1658-3175.8787

Rawan Saad Alghamdi, Ahmad A Mirza, Ibrahim Fae Asiri, Fatemah Samir Alghamdi, Nawaf Abdulaziz Alharthi, Shaymaa A Abdalal, Iman K Ramadan

{"title":"From Early Adversity to Adult Health: Quality-of-Life Consequences in A Mental Illness in Saudi Arabia.","authors":"Rawan Saad Alghamdi, Ahmad A Mirza, Ibrahim Fae Asiri, Fatemah Samir Alghamdi, Nawaf Abdulaziz Alharthi, Shaymaa A Abdalal, Iman K Ramadan","doi":"10.15537/1658-3175.8787","DOIUrl":"10.15537/1658-3175.8787","url":null,"abstract":"Objectives: Childhood trauma (CT) is prevalent among bipolar disorder (BD) patients and exacerbates clinical outcomes, which may impact the quality of life (QoL). This study explores the prevalence of CT and its association with QoL among BD patients in Saudi Arabia.Methods: Cross-sectional study conducted among adults with BD during the euthymic phase. Sample size was estimated using a single-proportion approach (target n=141), and participants recruited by convenience sampling of eligible outpatients. CT was assessed using the Childhood Trauma Questionnaire (CTQ), and QoL using the the Brief Quality of Life in Bipolar Disorder (Brief QoL.BD).Results: The CT prevalence was 90.1%, with physical neglect the most common type (78.7%). Mean QoL score was 36.2/60 (SD 10.7). Emotional neglect and emotional abuse had the most significant negative impact on QoL (mean differences: 9.6 points [95% CI: 6.4-12.8] and 6.4 points [95% CI: 3.0-9.9], respectively). In adjusted analyses, CT exposure, sex, age, and medication adherence were associated with QoL; the model explained 19% of QoL variability.Conclusion: The CT significantly impairs QoL in BD patients, particularly emotional neglect and abuse. Tailored interventions are essential for improving QoL in this population, particularly in culturally specific contexts such as the Middle East.","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 6","pages":"1031-1040"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Seroprevalence of Hepatitis B and Hepatitis C in Patients Hospitalized in Palliative Care Service. 姑息治疗住院患者乙型肝炎和丙型肝炎的血清阳性率。

IF 2.1 4区医学

Saudi Medical Journal Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.15537/1658-3175.8784

Meryem Betos Koçak, Burcu Güler

{"title":"Seroprevalence of Hepatitis B and Hepatitis C in Patients Hospitalized in Palliative Care Service.","authors":"Meryem Betos Koçak, Burcu Güler","doi":"10.15537/1658-3175.8784","DOIUrl":"10.15537/1658-3175.8784","url":null,"abstract":"Objectives: Patients receiving palliative care often have complex comorbidities and frequent healthcare exposure, which may place them at risk for blood-borne infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV). However, data on the seroprevalence and prognostic impact of these infections in palliative populations remain limited. This study aimed to determine the seroprevalence of HBV and HCV markers in patients hospitalized in a palliative care unit and to assess their association with mortality.Methods: This retrospective study conducted on 545 adult patients a tertiary palliative care unit between 2018 and 2024. Demographic characteristics, comorbidities, nutritional support, mobility, serological markers (HBsAg, anti-HBs, and anti-HCV), and outcomes were extracted from hospital records.Results: The mean age of patients was 76.3±15.1 years, and 52.8% were female. Malignancy was the most common comorbidity (50.5%), followed by infectious diseases (31.6%) and cardiovascular conditions. HBsAg positivity was identified in 0.6% of patients, anti-HBs in 31.2%, and anti-HCV in 0.2%. During hospitalization, 39.1% of patients died. Multivariate analysis revealed that chronic renal failure (HR=1.46, p=0.023), cardiac disease (HR= 3.11, p<0.001), immobility (HR=4.14, p<0.001), and HBsAg positivity (HR=6.91, p<0.001) were independent predictors of mortality.Conclusions: While the seroprevalence of active HBV and HCV infection was low in this palliative cohort, HBsAg positivity was associated with a significantly higher risk of mortality. The high proportion of patients lacking HBV immunity also highlights the need for strengthened infection control measures.","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 6","pages":"1008-1016"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Discharge Rates from Pediatric Emergency Departments Against Medical Advice can be Reduced by Improving Service Quality. 通过提高服务质量，可以减少儿科急诊科违背医嘱的出院率。

IF 2.1 4区医学

Saudi Medical Journal Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.15537/1658-3175.8796

Sounira Mehri, Josef Finsterer

引用次数: 0

Demographic Profiles, Clinical Characteristics, and Meteorological Context of Heat-Related Illnesses among Hajj Pilgrims in 2023. 2023年朝觐朝圣者热相关疾病的人口统计特征、临床特征和气象背景

IF 2.1 4区医学

Saudi Medical Journal Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.15537/1658-3175.8790

Ghadah Alsaleh, Majed Alsalamah, Fahad Alamri, Fatemah Alsaleh, Anas Khan

{"title":"Demographic Profiles, Clinical Characteristics, and Meteorological Context of Heat-Related Illnesses among Hajj Pilgrims in 2023.","authors":"Ghadah Alsaleh, Majed Alsalamah, Fahad Alamri, Fatemah Alsaleh, Anas Khan","doi":"10.15537/1658-3175.8790","DOIUrl":"10.15537/1658-3175.8790","url":null,"abstract":"Objective: To describe the demographic profiles, clinical characteristics, and meteorological context of heat-related illnesses among Hajj pilgrims in 2023.Methods: A retrospective cross-sectional study was conducted using data from 1,129 pilgrims diagnosed with HRIs across healthcare facilities in Mecca, Mina, and Arafat. Demographic and clinical data were extracted from the Hajj Health Information System, while temperature, humidity, wind speed, and rainfall records were obtained from the National Center for Meteorology.Results: Heat exhaustion (48.2%) and heatstroke (37.4%) were the most common diagnoses, with 24.9% of the cases requiring hospitalization. Males represented 55.4% of cases and accounted for 51.2% of hospitalizations. Pilgrims aged 55-74 years comprised 64.2% of severe cases, while Egyptians were disproportionately affected (32.2% of cases). Meteorological data revealed high temperatures reaching 44°C during the Day of Arafah, accompanied by low humidity (14%) and moderate wind speeds of approximately 7 km/h, with no rainfall (0 mm).Conclusion: The findings underscore the need for targeted interventions, including heat-adaptive rituals, real-time environmental monitoring, and age-specific cooling strategies, to protect pilgrims as climate change intensifies. This study provides a benchmark for future research on mass gatherings in warming environments.","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 6","pages":"1062-1070"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Re-Emergence of Pertussis in the Pediatric Population: A Tertiary Care Center's Experience. 百日咳在儿科人群中的再次出现：三级保健中心的经验。

IF 2.1 4区医学

Saudi Medical Journal Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.15537/1658-3175.8786

Haya S Alshaibani, Tahir K Hameed, Khaled H Alsager, Mohammed A Alshaalan, Syed F Jamil

{"title":"Re-Emergence of Pertussis in the Pediatric Population: A Tertiary Care Center's Experience.","authors":"Haya S Alshaibani, Tahir K Hameed, Khaled H Alsager, Mohammed A Alshaalan, Syed F Jamil","doi":"10.15537/1658-3175.8786","DOIUrl":"10.15537/1658-3175.8786","url":null,"abstract":"Objectives: To describe the 2024 surge in pertussis cases in the pediatric population in a large tertiary care center in Riyadh, Saudi Arabia.Methods: A retrospective observational study was conducted on children aged 0-14 years with PCR-confirmed Bordetella pertussis infection diagnosed at a tertiary hospital in Riyadh between January and December 2024. Patients older than 14 years, with negative or indeterminate PCR results, or diagnosed outside the study period were excluded, and demographic, immunization, clinical, and outcome data were analyzed.Results: A total of 36 children were diagnosed with pertussis, with 35 (97.2%) requiring hospital admission. The median age was 3.5 months (IQR: 2.0-19.0 months), and the most common presenting symptom was severe paroxysmal cough, reported in 32 (88.9%) patients. Nine (25%) patients required pediatric intensive care unit admission, and one death occurred. Nearly 80% of patients were unvaccinated infants or under-vaccinated, and approximately half had a history of suspected or confirmed adolescent or adult household contact with pertussis.Conclusion: A significant number of pediatric pertussis cases were observed in 2024, representing a 12-fold rise compared with 2023 and mirroring global outbreaks. Most patients were infants who were too young to be vaccinated or children who had not received the full series of pertussis vaccinations, and many had adolescent/adult household contacts. Our study supports the need for booster vaccinations in the adolescent population and pregnant women.","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 6","pages":"1026-1030"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial Intelligence in Dialysis Therapies: Applications in Hemodialysis and Peritoneal Dialysis for Managing Infectious Diseases and Complications. 透析治疗中的人工智能：在血液透析和腹膜透析中的应用，以管理传染病和并发症。

IF 2.1 4区医学

Saudi Medical Journal Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.15537/1658-3175.8783

Waleed H Mahallawi

{"title":"Artificial Intelligence in Dialysis Therapies: Applications in Hemodialysis and Peritoneal Dialysis for Managing Infectious Diseases and Complications.","authors":"Waleed H Mahallawi","doi":"10.15537/1658-3175.8783","DOIUrl":"10.15537/1658-3175.8783","url":null,"abstract":"This narrative review synthesizes evidence from a systematic literature search (2019-2025) on artificial intelligence (AI) applications in hemodialysis and peritoneal dialysis for managing infections and complications. Dialysis patients face infection rates 100-fold higher than the general population and sepsis mortality exceeding 35%. The AI, utilizing machine learning algorithms such as XGBoost, deep neural networks, and explainable AI tools, revolutionizes care through precise diagnostics, prognostics, and therapeutics. Key models demonstrate high accuracy in predicting bloodstream infections (area under the curve [AUC] 0.914), classifying peritonitis (F1 0.93), detecting SARS-CoV-2 (AUROC 0.82), and forecasting mortality (AUC 0.979). Therapeutically, AI guides antibiotic stewardship, reducing inappropriate use by 18-67%, and mitigates intradialytic hypotension via ultrafiltration adjustments, reducing incidence by 25-40%. Despite promising results, challenges include data scarcity, algorithmic bias, and the integration of these tools into clinical workflows. Future directions involve diverse datasets, explainable AI, and real-time decision support systems. The AI holds transformative potential for personalizing dialysis management and improving patient outcomes.","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 6","pages":"998-1007"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Treatment on the Health-Related Quality of Life of Children with Cancer in Saudi Arabia. 治疗对沙特阿拉伯癌症儿童健康相关生活质量的影响

IF 2.1 4区医学

Saudi Medical Journal Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.15537/1658-3175.8780

Fayzah Hussain Alhussain, Amany Anwar Saeed Alabdullah

{"title":"Impact of Treatment on the Health-Related Quality of Life of Children with Cancer in Saudi Arabia.","authors":"Fayzah Hussain Alhussain, Amany Anwar Saeed Alabdullah","doi":"10.15537/1658-3175.8780","DOIUrl":"10.15537/1658-3175.8780","url":null,"abstract":"Objective: The impact of cancer on health-related quality of life (HRQOL) is considerable, particularly for children undergoing oncological treatment. While research has addressed HRQOL in childhood cancer survivors, less attention has been given to those actively undergoing treatment, including in Saudi Arabia. This systematic review aimed to address this gap by quantitatively evaluating studies reporting on the HRQOL of children in Saudi Arabia during their active cancer treatment phase. We also compare these findings with studies from around the world, emphasising demographic, medical and parental predictors of HRQOL.Methods: A comprehensive search of relevant databases (MEDLINE, CENTRAL, Embase, PsycINFO and CINAHL) was conducted to identify studies assessing HRQOL in pediatric cancer patients, both in Saudi Arabia and globally. A narrative synthesis was performed.Results: Nine studies met the inclusion criteria, involving 907 pediatric cancer patients. All children undergoing treatment experienced a decline in HRQOL. In Saudi Arabia, the psychosocial domain was especially affected. Children in the newly diagnosed phase reported the lowest HRQOL. Longitudinal studies showed improvement over time. Clinical, demographic and parental factors were found to influence HRQOL.Conclusion: Pediatric cancer patients face significant physical, emotional and psychosocial challenges. Tailored interventions and the integration of paediatric palliative care are urgently needed to improve HRQOL. This review highlights the need for more in-depth research in Saudi Arabia to inform clinical practices and optimise outcomes for children with cancer.","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 6","pages":"972-980"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Male Pelvic Health in Saudi Arabia: Knowledge-Practice Gap in Pelvic Floor Muscle Exercises and Implications for Preventive Physiotherapy and Health Policy. 沙特阿拉伯男性盆腔健康：盆底肌肉锻炼的知识与实践差距及其对预防性物理治疗和健康政策的影响

IF 2.1 4区医学

Saudi Medical Journal Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.15537/1658-3175.8791

Wael A S Alghamdi

{"title":"Male Pelvic Health in Saudi Arabia: Knowledge-Practice Gap in Pelvic Floor Muscle Exercises and Implications for Preventive Physiotherapy and Health Policy.","authors":"Wael A S Alghamdi","doi":"10.15537/1658-3175.8791","DOIUrl":"10.15537/1658-3175.8791","url":null,"abstract":"Objectives: To assess the knowledge, attitudes, and practices (KAP) of Saudi men toward pelvic floor muscle training (PFMT) and to identify demographic and clinical predictors of awareness and practice.Methods: A cross-sectional survey was conducted among 458 Saudi men in Al-Baha using a validated Arabic questionnaire adapted from the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), and International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF). Data were analyzed with chi-square tests, analysis of variance (ANOVA) and reliability testing (Cronbach's α= 0.862).Results: Awareness of PFMT was moderate (63.1%), but only 13.1% knew how to perform PFMT correctly. Attitudes were largely positive (72.9%), citing benefits such as relief of back/pelvic pain (33.7%) and core strengthening (32.9%). Practice was limited, with only 11.6% performing PFMT regularly. Knowledge and positive attitudes were significantly associated with practice (χ2, p <0.001). Urinary incontinence was uncommon (86% reported none), though symptoms such as incomplete bladder emptying (27.7%) and defecation difficulty (31%) were frequent. Older men (≥55 years) and divorced men reported significantly higher symptom scores (p <0.01).Conclusion: This first KAP study of PFMT among Saudi men demonstrated a gap between awareness and regular practice. The findings highlight the need for physiotherapist-led education, structured skills training, and scalable digital platforms to transform awareness into sustainable practice and improve men's pelvic health.","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 6","pages":"1071-1078"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Obesity's Role in Stroke Incidence Among Smokers: An Assessment of Confounding, Interaction, and Mediation Effects. 肥胖在吸烟者中风发病率中的作用：混杂、相互作用和中介效应的评估。

IF 2.1 4区医学

Saudi Medical Journal Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.15537/1658-3175.8789

Saeed Awad M Alqahtani, Moutasem Salih Aboonq

{"title":"Obesity's Role in Stroke Incidence Among Smokers: An Assessment of Confounding, Interaction, and Mediation Effects.","authors":"Saeed Awad M Alqahtani, Moutasem Salih Aboonq","doi":"10.15537/1658-3175.8789","DOIUrl":"10.15537/1658-3175.8789","url":null,"abstract":"Objectives: To examine the association between body mass index (BMI) category and history of stroke among current smokers, while assessing potential confounding, effect modification by age, and mediation by cardiovascular comorbidities.Methods: Data were analyzed from 53,939 current adult smokers participating in the 2021 Behavioral Risk Factor Surveillance System (BRFSS). Survey-weighted logistic regression estimated the association between BMI categories (underweight, normal, overweight, obese) and self-reported stroke history. The study assessed multicollinearity and adjusted for sociodemographic and health variables. Interaction terms were tested to evaluate effect modification by age, and exploratory decomposition analysis was used to assess mediation by conditions such as hypertension and diabetes.Results: Stroke prevalence was highest among underweight smokers (6.3%). In adjusted models, the association between high BMI and stroke was attenuated or null. A significant interaction between BMI and age was identified; while younger underweight smokers showed lower stroke odds, older obese smokers exhibited odds ratios near or below 1.0 (such as ages 60-64: OR 0.70; 95% CI: 0.57-0.87), consistent with an \"obesity paradox.\" Mediation analysis indicated that traditional cardiovascular risk factors did not mediate the relationship in underweight or overweight groups, with only partial mediation by hypertension and myocardial infarction observed in obese smokers.Conclusion: Among smokers, BMI is not consistently associated with increased stroke risk, and its impact is strongly modified by age. The findings suggest that the potent vascular toxicity of smoking may overwhelm or alter typical weight-related risk pathways, reinforcing smoking cessation as the primary preventive strategy.","PeriodicalId":21453,"journal":{"name":"Saudi Medical Journal","volume":"47 6","pages":"1051-1061"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0