Annals of Thoracic Medicine最新文献

{"title":"Outcomes of patients admitted to the intensive care unit with community-acquired pneumonia in a tertiary care center in Riyadh, Saudi Arabia","authors":"Talal Oreibi, Farhan Alenezi, Amjad M. Ahmed, Felwa Bin Humaid, Musharaf Sadat, Hani Mohammed Tamim, Faisal Fouad Baseet, Brintha Naidu, Yaseen M. Arabi","doi":"10.4103/atm.atm_49_23","DOIUrl":"https://doi.org/10.4103/atm.atm_49_23","url":null,"abstract":"Abstract: BACKGROUND: Community-acquired pneumonia (CAP) is a leading cause of intensive care unit (ICU) morbidity and mortality. Despite extensive international epidemiological and clinical studies to improve those patients’ outcomes, local statistics in Saudi Arabia are limited. The objective of this study is to describe the clinical characteristics and outcomes of patients admitted to the ICU with the diagnosis of CAP reflecting the experience of a tertiary center over an 18-year period. METHODS: A retrospective cohort study included all consecutive adult ICU patients diagnosed with CAP between 1999 and 2017. Baseline demographics, patients’ risk factors, and initial admission laboratory investigations were compared between survivors and nonsurvivors. A multivariate regression model was used to predict mortality. RESULTS: During the study period, there were 3438 patients admitted to the ICU with CAP (median age 67 [Quartile 1, 3 (Q1, Q3) 51, 76] years) and 54.4% were males, of whom 1007 (29.2%) died. The survivors compared with nonsurvivors were younger (65 vs. 70 years), less likely to have chronic liver disease (2.4% vs. 10.5%), chronic renal failure (8.1% vs. 14.4%), and be immunocompromised (10.2% vs. 18.2%), and less frequently required mechanical ventilation or vasopressors (46.2% vs. 80.5% and 29.6% vs. 55.9%, respectively). Acute Physiology and Chronic Health Evaluation (APACHE) II score was significantly higher among nonsurvivors (median score 26 vs. 20) with a longer duration of mechanical ventilation and ICU stay. Using a multivariate regression model, age, APACHE II score, bilirubin level, vasopressors, and mechanical ventilation were significantly associated with increased mortality, while diabetes was associated with lower mortality. CONCLUSION: Around one-third of patients admitted to the ICU with CAP died. Mortality was significantly associated with age, APACHE II score, vasopressor use, and mechanical ventilation. A comprehensive national registry is needed to enhance epidemiological data and to guide initiatives for improving CAP patients’ outcomes.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135008602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased airway resistance among exclusive waterpipe smokers detected using impulse oscillometry.","authors":"Hassan A Chami,&nbsp;Nourhan Houjeij,&nbsp;Maha Makki,&nbsp;Lina Itani,&nbsp;Hani Tamim,&nbsp;Ahmad Al Mulla,&nbsp;Bartolome Celli,&nbsp;Salah Zeineldine","doi":"10.4103/atm.atm_165_22","DOIUrl":"10.4103/atm.atm_165_22","url":null,"abstract":"<p><strong>Introduction: </strong>Waterpipe smoking is increasing in popularity, yet the evidence implicating waterpipe smoking in lung disease is limited. We hypothesized that impulse oscillometry (IOS) would detect airway abnormalities in waterpipe smokers (WPS).</p><p><strong>Methods: </strong>We studied 210 participants, 40 years or older, from the community, of whom 92 were exclusive WPS and 118 were never-smokers. Waterpipe smoking history was assessed using a validated questionnaire. All participants underwent spirometry, and IOS and absolute and percentage predicted results (for age, sex, height, and weight) were compared between WPS and nonsmokers. The association of IOS parameters with waterpipe smoking duration and extent (waterpipe smoked/day * smoking duration) was evaluated using linear regression.</p><p><strong>Results: </strong>WPS smoked on average 1.8 ± 1.2 waterpipes/day, over an average duration of 23.3 ± 39.8 years. WPS and nonsmokers were largely asymptomatic and had similar age, body mass index, sex distribution, and spirometric values. Nevertheless, WPS had higher IOS measured resistance at 5Hz compared to nonsmokers, (0.53 ± 0.2 vs. 0.48 ± 0.2 kPa/L/s, <i>P</i> = 0.03) and higher percentage-predicted resistance (124.5 ± 36.3 vs. 115.7% ± 35.6%, <i>P</i> = 0.04). Waterpipe smoking duration was also associated with resistance (β = 0.04 kPa/L/s/year, <i>P</i> = 0.01) and with percentage-predicted resistance (β = 0.05/year, <i>P</i> = 0.02). Waterpipe smoking extent was associated with resistance (β = 0.009 kPa/L/s/waterpipe-year, <i>P</i> = 0.04), while the association with percentage-predicted resistance was near significance (β = 0.009/waterpipe-year, <i>P</i> = 0.07).</p><p><strong>Conclusions: </strong>Waterpipe smoking is associated with increased airway resistance assessed by IOS but not by spirometry in largely asymptomatic individuals from the community.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 1","pages":"23-30"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/9c/ATM-18-23.PMC10034824.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9191291","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}

{"title":"Retransplantation for COVID-19-related lung graft failure: A case report of successful outcome in a critically ill lung transplant recipient","authors":"Prince Ntiamoah, Marie Budev, Jason Turowski, Charles Randall Lane, Kenneth R. McCurry","doi":"10.4103/atm.atm_107_23","DOIUrl":"https://doi.org/10.4103/atm.atm_107_23","url":null,"abstract":"Abstract: End-stage lung disease from nonrecovered COVID-19 acute respiratory distress syndrome has become an increasingly frequent indication for lung transplant. Although reports of lung transplant recipients (LTRs) with COVID-19 suggest an increased risk for hospitalization, respiratory failure, and death, little is known about retransplant for COVID-19-related lung graft failure. In this manuscript, we present a 49-year-old man who received bilateral lung retransplantation for COVID-19-related lung graft failure, 7½ years after his initial transplant for idiopathic pulmonary fibrosis. Our case suggests that retransplantation may be a viable option for critically ill LTRs with COVID-19-related graft failure, even in the presence of other organ dysfunction, provided that they are in good condition and have an immunologically favorable donor.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"198 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135009165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-COVID-19 pulmonary fibrosis: An ongoing concern","authors":"Nuha Nasser Alrajhi","doi":"10.4103/atm.atm_7_23","DOIUrl":"https://doi.org/10.4103/atm.atm_7_23","url":null,"abstract":"Abstract: Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 rapidly spread across the globe causing over 6 million deaths and major compromization of health facilities. The vast majority of survivors post-COVID-19 are left with variable degrees of health sequelae including pulmonary, neurological, psychological, and cardiovascular complications. Post-COVID-19 pulmonary fibrosis is one of the major concerns arising after the recovery from this pandemic. Risk factors for post-COVID-19 pulmonary fibrosis include age, male sex, and the severity of COVID-19 disease. High-resolution computed tomography provides diagnostic utility to diagnose pulmonary fibrosis as it provides more details regarding the pattern and the extent of pulmonary fibrosis. Emerging data showing similarities between post-COVID-19 pulmonary fibrosis and idiopathic pulmonary fibrosis, finding that needs further exploration. The management of post-COVID-19 pulmonary fibrosis depends on many factors but largely relies on excluding other causes of pulmonary fibrosis, the extent of fibrosis, and physiological impairment. Treatment includes immunosuppressants versus antifibrotics or both.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When single-inhaler triple therapy is a preferred option in asthma management?","authors":"Mohamed S Al-Moamary,&nbsp;Riyad Al-Lehebi,&nbsp;Majdy M Idrees,&nbsp;Mohammed O Zeitouni","doi":"10.4103/atm.atm_341_22","DOIUrl":"https://doi.org/10.4103/atm.atm_341_22","url":null,"abstract":"<p><p>Asthma control is the main goal of management. Unfortunately, most asthma patients with moderate-severe asthma remain uncontrolled despite receiving standard treatment of inhaled corticosteroids (ICS) with long-acting β2 agonists (LABA). The addition of long-acting antimuscarinic agents (LAMA) has been shown to improve different aspects of asthma control, including symptoms, lung functions, and probably exacerbations. Such an option could be considered for low-T2 asthma phenotype. Umeclidinium and glycopyrronium bromide are other LAMA agents that have been recently made available in combination with ICS and LABA in single-inhaler triple therapy (SITT) devices. Here, we discuss the position of SITT as a new novel therapeutic option in asthma management and its clinical benefits, potential cost saving, and improved compliance.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"17 4","pages":"185-188"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/be/ATM-17-185.PMC9662080.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40493253","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}

{"title":"Coinfection of pulmonary tuberculosis with other lower respiratory tract infections: A retrospective cross-sectional study.","authors":"Marwh G Aldriwesh,&nbsp;Raghad A Alaqeel,&nbsp;Aisha M Mashraqi,&nbsp;Mutaib M Mashraqi,&nbsp;Bayan A Albdah,&nbsp;Azzah S Alharbi","doi":"10.4103/atm.atm_200_22","DOIUrl":"https://doi.org/10.4103/atm.atm_200_22","url":null,"abstract":"<p><strong>Background: </strong>Little attention has been given to the development of lower respiratory tract infections (LRTIs) in patients with pulmonary tuberculosis (PTB) during their anti-tuberculosis (anti-TB) treatment and how that might affect patients' health status. Here, the prevalence and etiologies of other LRTIs in a cohort of PTB patients were determined, and the clinical features and outcomes were described.</p><p><strong>Methods: </strong>Adult patients with PTB between 2015 and 2020 were recruited and monitored during their anti-TB treatment for the presence of LRTIs. Clinical data were retrospectively collected from patients' medical records.</p><p><strong>Results: </strong>Data from 76 PTB patients (57 [75%] males) were reviewed. The median age was 61.0 (interquartile range 83.5-35.5) years, and other LRTIs were detected in 45 (59.2%) PTB patients. Of the 126 episodes of LRTIs, 84 (66.7%) were due to bacterial infections, 37 (29.4%) were due to fungal infections, and 5 (3.9%) were due to viral infections. The development of LRTIs was significantly more common in older (<i>P</i> = 0.012) and hypertensive patients with PTB (<i>P</i> = 0.019). Patients with PTB and LRTIs experienced significantly more frequent extrapulmonary infections (<i>P</i> = 0.0004), bloodstream infections (<i>P</i> = 0.001), intensive care unit stays (<i>P</i> = 0.001), and invasive mechanical ventilation use (<i>P</i> = 0.03) than patients who did not develop LRTI.</p><p><strong>Conclusions: </strong>The identification of host-related risk factors for LRTI development among patients with PTB could be used to develop a prediction model for LRTI development. Hence, initiating antimicrobials early, in parallel with appropriate anti-TB treatment, may mitigate PTB-related health and economic consequences.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"17 4","pages":"229-236"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/9b/ATM-17-229.PMC9662083.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40493254","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}

{"title":"Comparing the characteristics of positional and nonpositional sleep apnea patients among the Jordanian population.","authors":"Khaled Al Oweidat,&nbsp;Ahmad A Toubasi,&nbsp;Asma S Albtoosh,&nbsp;Eyad Al-Mefleh,&nbsp;Manar M Hasuneh,&nbsp;Ahmed A Abdulelah,&nbsp;Rima A Sinan","doi":"10.4103/atm.atm_214_22","DOIUrl":"https://doi.org/10.4103/atm.atm_214_22","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a common cause of sleep-disordered breathing with a large proportion of the patients exhibiting positional OSA (POSA). In this study, we aimed to evaluate the differences in the demographics, comorbidities, and polysomnographic features between POSA and non-POSA (NPOSA) in a Jordanian sample to further discern the propulsive elements for each group.</p><p><strong>Methods: </strong>In this study, we evaluated 1037 adult patients with OSA. POSA was defined as an overall apnea and hypopnea index (AHI) >5, an overall AHI severity at least 1.4 times the nonsupine severity (overall/NS-AHI), and a minimum amount of time (i.e., 20 min) in the supine and nonsupine positions. To compare the clinical characteristics between POSA and NPOSA patients, statistical analyses were performed.</p><p><strong>Results: </strong>The prevalence of POSA was 41.7%. In comparison to NPOSA patients, POSA patients had higher female sex prevalence, milder OSA, lower body mass index, lower hypertension prevalence, and lower hemoglobin A1C levels compared to NPOSA patients. Moreover, sleep efficiency, total sleep time, and supine sleep time were significantly higher in POSA patients. Nonsupine sleep time, total AHI, rapid eye movement (REM) AHI, non-REM (NREM) AHI, supine AHI, nonsupine AHI, left and right AHI, mean oxyhemoglobin saturation (SpO₂) awake, mean REM and NREM SpO₂, SpO₂ nadir, and time SpO₂ below 90% were significantly lower among POSA patients. The multivariate regression analysis showed that only female gender and hypertension were significantly associated with POSA.</p><p><strong>Conclusion: </strong>POSA is common among OSA patients and demonstrates different clinical characteristics in comparison to NPOSA. Future prospective studies are needed to better characterize the POSA patients and investigate the benefit of positional therapy.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"17 4","pages":"207-213"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/e0/ATM-17-207.PMC9662084.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40690417","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}

{"title":"Incidence and profile of severe exacerbations of chronic obstructive pulmonary disease due to biomass smoke or tobacco.","authors":"Rafael Golpe,&nbsp;Nagore Blanco-Cid,&nbsp;David Dacal-Rivas,&nbsp;Irene Martín-Robles,&nbsp;Iria Veiga,&nbsp;Indhira Guzmán-Peralta,&nbsp;Olalla Castro-Añón,&nbsp;Luis A Pérez-de-Llano","doi":"10.4103/atm.atm_155_22","DOIUrl":"https://doi.org/10.4103/atm.atm_155_22","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Stable chronic obstructive pulmonary disease (COPD) caused by biomass smoke (B-COPD) has some differences from tobacco-induced-COPD (T-COPD), but acute exacerbations (AECOPD) have not been well characterized in B-COPD.</p><p><strong>Objective: </strong>To compare the incidence, characteristics and outcomes of AECOPD in B-COPD with those of T-COPD.</p><p><strong>Methods: </strong>A retrospective observational study that included consecutive patients seen at a specialized COPD clinic (2008-2021). The incidence of severe AECOPD that required hospital admission was studied. For the first AECOPD, the following variables were recorded: fever, coexistence of pneumonia, purulent sputum, eosinophil count, neutrophil to lymphocyte ratio, hypercapnia, and respiratory acidosis. Outcome variables were intensive care unit (ICU) admission, length of hospital stay, and mortality within 1 month of hospital admission.</p><p><strong>Results: </strong>Of 1060 subjects, 195 (18.4%) belonged to the B-COPD group and 865 (81.6%) to the T-COPD group. During a follow-up of 67.9 (37.8-98.8) months, 75 (38.4%) patients in the B-COPD group and 319 (36.8%) in the T-COPD group suffered at least one severe AECOPD. The only difference between groups was in a higher risk of ICU admission for the T-COPD group. The incidence, characteristics, and the rest of the outcomes of AECOPD were similar for both groups.</p><p><strong>Conclusion: </strong>AECOPD are similar events for B-COPD and T-COPD and should be managed similarly.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"17 4","pages":"193-198"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/6d/ATM-17-193.PMC9662078.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40691392","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}

{"title":"Lung cancer screening in the gulf: Rationale and recommendations.","authors":"Sami M Bennji,&nbsp;B Jayakrishnan,&nbsp;Adil H Al-Kindi,&nbsp;Issa Al-Jahdhami,&nbsp;Zamzam Al-Hashami","doi":"10.4103/atm.atm_69_22","DOIUrl":"https://doi.org/10.4103/atm.atm_69_22","url":null,"abstract":"<p><p>Lung cancer is the leading cause of cancer-related death worldwide among both men and women. Although advances in therapy have been made, the 5-year survival rates for lung cancer remain poor, ranging from 10% to 20%. One of the main reasons is late presentation, as only 25% of patients are amenable to cure at the time of presentation. Therefore, the emphasis on lung cancer screening (LCS) is growing with the current evidence that has shown benefits with low-dose computed tomography scan of the chest in high-risk populations. LCS remains a debated topic in Gulf Cooperation Council (GCC) countries, possibly due to a lack of local experience. In this article, we explore the rationale and give recommendations on the best approach for LCS in GCC.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"17 4","pages":"189-192"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/fc/ATM-17-189.PMC9662086.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40493255","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}

{"title":"Acute chest syndrome in pediatric sickle cell disease: A 19-year tertiary center experience.","authors":"Abdullah A Yousef,&nbsp;Hwazen A Shash,&nbsp;Ali N Almajid,&nbsp;Ammar A Binammar,&nbsp;Hamza Ali Almusabeh,&nbsp;Hassan M Alshaqaq,&nbsp;Mohammad H Al-Qahtani,&nbsp;Waleed H Albuali","doi":"10.4103/atm.atm_575_21","DOIUrl":"https://doi.org/10.4103/atm.atm_575_21","url":null,"abstract":"<p><strong>Introduction: </strong>The most common cause of death among sickle cell disease (SCD) patients is acute chest syndrome (ACS). Since SCD is a common condition in the Eastern province of the Kingdom of Saudi Arabia (KSA), we aimed to provide a detailed description of the clinical characteristics and ACS management.</p><p><strong>Methods: </strong>We retrospectively studied pediatric (<14 years) patients with SCD diagnosis who were admitted with ACS or developed ACS after admission from January 2002 to December 2020. The absence of chest X-ray or hemoglobin electrophoresis was the reason to exclude patients from the study. The primary objective of the study was to evaluate and report the clinical, laboratory, and management characteristics of ACS.</p><p><strong>Results: </strong>Ninety-one ACS episodes (42 patients) were included, with a mean diagnosis age of 7.18 ± 3.38 years. Twenty-two (52.4%) patients were male. Twenty-five patients had recurrent ACS episodes. The median absolute number of ACS was 3.5 (interquartile range [IQR], 2-9), with maximum ACS episodes of 13/1 year and a minimum of 1 ACS episode per year. At the first ACS episode, the mean age was 6.62 ± 3.38 years, while the overall mean age at ACS episode diagnosis was 7.18 ± 3.38 years. The most common antecedent events were vaso-occlusive crisis (12 episodes, 13.2%) and upper respiratory tract infections (8 episodes, 8.8%). The most frequently encountered presenting symptoms were fever (70.3%) and cough (70.3%). The most common antibiotics used were azithromycin (82.4%) and ceftriaxone (75.8%). Nine patients (9.9%) required pediatric intensive care unit (PICU) admission. Of the 91 ACS episodes, there was no in-hospital mortality. The median hospital and PICU length of stay were 8 days (IQR, 5-10.25) and 4 days (IQR, 3-5.5), respectively.</p><p><strong>Conclusion: </strong>This study has reported the most common clinical characteristics and management of ACS among pediatric SCD patients in the Eastern province of KSA.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"17 4","pages":"199-206"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/5c/ATM-17-199.PMC9662085.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40690411","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}