scholarly journals Association between Emergency Department Overcrowding and Mortality at a Teaching Hospital in Saudi Arabia

2020 ◽  
Vol 13 (1) ◽  
pp. 756-762
Author(s):  
Fatimah Yahyia Khubrani ◽  
Mona Faisal Al-Qahtani
Keyword(s):  
Saudi Arabia ◽  
Mortality Rate ◽  
Teaching Hospital ◽  
Public Awareness ◽  
Patient Capacity ◽  
Number Of Patients ◽  
Ed Overcrowding ◽  
Healthcare Crisis ◽  
Professional Assistance ◽  
Occupancy Rates

Introduction: Emergency Departments (ED) are highly important in hospital settings because they offer 24-hour professional assistance to patients in need of healthcare. However, ED overcrowding has started to become a global healthcare crisis, such that the patient capacity of EDs is no longer sufficient to meet patient demand. Aim: Thus, this study aimed to determine the relationship between ED overcrowding and the mortality rate of patients to draw the attention of decision makers in Saudi Arabia toward this issue, with the hope of ultimately attaining a solution to this problem. Methods: Using patients’ electronic health records that were stored in the Quadra Med system in 2018, we calculated the occupancy rates of the ED of a target teaching hospital at different quarters and associated those figures with the mortality rates for the same quarters. Results: Our results showed that there was no significant association between mortality rate and crowding status in the ED. Nonetheless, we recommend increasing public awareness and bed capacity at EDs in Saudi Arabia because overcrowded EDs can lead to adverse patient outcomes. Conclusion: The present study showed that the highest percentage (38%) of deaths that occurred during the overcrowded period were mostly of patients between 30 and 44 years of age, while patients between 60 and 74 years of age accounted for 36% of deaths. The current study also assessed patient triaging, revealing that the highest number of patients was associated with level four (62.7% of the total patients in the overcrowded ED) and level five (33.1% in the overcrowded ED) triaging. We also discovered higher levels of admission in the critical care unit during the ED overcrowding period compared with other periods.

scholarly journals SEPTICEMIA;

2012 ◽  
Vol 19 (06) ◽  
pp. 808-811
Author(s):  
SAEMA TEHSEEN ◽  
AFIFA WAHEED ◽  
NABEELA SHAMI
Keyword(s):  
Study Design ◽  
Teaching Hospital ◽  
Public Awareness ◽  
Developed Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Elective Termination ◽  
Complete History ◽  
Definite Role

Induced Miscarriage is defined as the elective termination of pregnancy before 24 weeks of gestation. Objectives: To determinethe frequency of sepsis associated with induced Miscarriage. Study Design: Cross-sectional survey. Setting: Department of Obstetrics andGynaecology, Unit-II, Ghurki Trust Teaching Hospital, Lahore. Duration of Study: Six months from 25-12-08 to 24-06-09. Materials andMethods: Total 110 cases were taken. Complete history including parity and mode of admission was taken. All information was recorded onspecially designed proforma. Results: A large number of patients turned out to be para 3-4 i.e. 87 (79%), 15 cases (13.7%) had the paritybetween 5-7 and only 8 cases (7.3%) were para 1-2 (Table-I).On analyzing the mode of admission it was found that 50 (45.4%) patients wereadmitted through out-patient department. 60 cases (54.6%) were admitted through emergency (Table-II). Finally the frequency of sepsisamongst women presenting with Miscarriage was calculated and it was found to be 25 (22.7%). 85 (77.3%) cases did not show any evidence ofsepsis (Table-III). Conclusions: Illegal Miscarriages are a major contribution to septic morbidity leading to a large number of maternal deathswhich is a dilemma in under developed countries like ours. Better public awareness and access to contraceptive measures has a definite role toplay in improving the outcome.

Management of complex CHD at the National Cardiothoracic Center of Excellence, University of Nigeria Teaching Hospital, Enugu: the role of foreign cardiac missions in 3.5 years

2017 ◽  
Vol 27 (6) ◽  
pp. 1174-1179
Author(s):  
Ikechukwu A. Nwafor ◽  
Josephat M. Chinawa ◽  
Daberechi K. Adiele ◽  
Ijeoma O. Arodiwe ◽  
Ndubueze Ezemba ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Surgical Management ◽  
Teaching Hospital ◽  
Structural Defect ◽  
Center Of Excellence ◽  
Number Of Patients ◽  
Nigeria Teaching Hospital ◽  
Surgical Options ◽  
Age Range

AbstractBackgroundCHD is defined as structural defect(s) in the heart and proximal blood vessels present at birth. The National Cardiothoracic Center of Excellence, University of Nigeria Teaching Hospital (UNTH), Enugu, through the aid of visiting Cardiac Missions has managed a significant number of patients within the last 3.5 years.Aim/ObjectiveThe objective of this study was to review surgical options and outcome of complex CHD among patients attending UNTH, Enugu, Enugu.Materials and MethodDuring the period of 3.5 years (March, 2013 to June, 2016), a total of 20 cases of complex CHD were managed by cardiac missions that visited UNTH, Enugu. Their case notes and operating register were retrieved, reviewed, and analysed using SPSS version 19 (Chicago).ResultsThere were eight females and 12 males, with a ratio of 2:5. The age range was from 5 months to 34 years with a mean of 1.7. Among all, five patients died giving a mortality rate of 25%. The operative procedures ranged from palliative shunts to complete repair. The outcome was relatively good.ConclusionComplex CHD are present in our environment. Their surgical management in our centre is being made possible by periodic visits of foreign cardiac missions.

scholarly journals Leaving The Emergency Department Without Being Seen or Without Complete Treatment; A Study From Saudi Arabia

2021 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Mishal Abdulrahman Almarshady ◽  
Sharafaldeen Bin Nafisah ◽  
Yousef Almubarak ◽  
Husam Althobyane
Keyword(s):  
Emergency Department ◽  
Saudi Arabia ◽  
Mortality Rate ◽  
Waiting Time ◽  
Management Strategies ◽  
Tertiary Hospital ◽  
Health Concern ◽  
Contributing Factors ◽  
Number Of Patients ◽  
The Impact

Background, The attitude of Leaving the emergency department (ED) without being seen or without completing treatment is attributed to prolonged waiting time. The impact of such behaviour and fate of such patients remain undetermined. Aim This study aimed to investigate the prevalence of Left Without Being Seen (LWBS) and Left Without Completing Treatment (LWCT), analyse the contributing factors for such behaviour and the mortality rate within one week of leaving the ED. Methods A retrospective observational study was performed in a tertiary hospital in Riyadh, Saudi Arabia, for three months. All adult patients of more than  14  years of age who visited the ED and LWBS or LWCT were included. Patients were seen by physicians and triaged-out, and those who were directed towards the outpatient clinic were excluded. Patients were asked about the reason for leaving, and their intention to return to the same ED again via call. Results The total number of LWBS and LWCT was 286 patients, with a response rate of 75%. The mean age was 45.8 years. About 46.6% sought medical help within seven days of leaving ED. However, the mortality rate was nil. Many patients (69.3%) reported their intention to revisit the same ED in the near future. A positive correlation was found between increasing age and admission within the same seven days’ period. Conclusion Prolonged waiting time is a public health concern that needs management strategies, the number of patients whom LWBS and LWCT require continuous monitoring and exploration.

scholarly journals Molecular Survey of Vector-Borne Pathogens of Dogs and Cats in Two Regions of Saudi Arabia

Pathogens ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 25
Author(s):  
Abdullah D. Alanazi ◽  
Abdulaziz S. Alouffi ◽  
Mohamed S. Alyousif ◽  
Mohammad Y. Alshahrani ◽  
Hend H. A. M. Abdullah ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Real Time ◽  
Real Time Pcr ◽  
Bartonella Henselae ◽  
Public Awareness ◽  
Effective Control ◽  
Vector Borne Diseases ◽  
Babesia Vogeli ◽  
Vector Borne ◽  
First Time

Dogs and cats play an important role as reservoirs of vector-borne pathogens, yet reports of canine and feline vector-borne diseases in Saudi Arabia are scarce. Blood samples were collected from 188 free-roaming dogs and cats in Asir (70 dogs and 44 cats) and Riyadh (74 dogs), Saudi Arabia. The presence of Anaplasma spp., Bartonella spp., hemotropic Mycoplasma spp., Babesia spp., and Hepatozoon spp. was detected using a multiplex tandem real-time PCR. PCR-positive samples were further examined with specific conventional and real-time PCR followed by sequencing. Dogs from Riyadh tested negative for all pathogens, while 46 out of 70 dogs (65.7%) and 17 out of 44 cats (38.6%) from Asir were positive for at least one pathogen. Positive dogs were infected with Anaplasma platys (57.1%), Babesia vogeli (30%), Mycoplasma haemocanis (15.7%), and Bartonella henselae (1.4%), and cats were infected with Mycoplasma haemofelis (13.6%), Candidatus Mycoplasma haemominutum (13.6%), B. henselae (9.2%), and A. platys (2.27%), all of which are reported for the first time in Saudi Arabia. Co-infection with A. platys and B. vogeli was detected in 17 dogs (24.28%), while coinfections were not detected in cats. These results suggest that effective control and public awareness strategies for minimizing infection in animals are necessary.

A Prospective Observational Study on Prevalence and Prognostic Indicators among Tuberculosis and Multidrug Resistance Tuberculosis Patients in Tertiary Care Teaching Hospital

2021 ◽  
pp. 43-48
Author(s):  
A. Noorjahan ◽  
B. Bhargavi ◽  
K. Mallikarjuna ◽  
B. Mohammad Ishaq ◽  
L. Siva Sankar Reddy ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
Observational Research ◽  
Prognostic Indicators ◽  
Treatment Result ◽  
High Morbidity ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Number Of Patients ◽  
Mdr Tb

Tuberculosis (TB) is a communicable systemic infectious disease with high morbidity and mortality associated with it. Resistance to medications used to treat tuberculosis has been on the rise in recent years. (multidrug-resistant tuberculosis)  (MDR-TB)  is a significant challenge to (TB) control around the world. An observational research was conducted in a tertiary care teaching hospital to determine the interim pharmacological and microbial results of Rifampicin resistance TB patients. Data from Santhiram Medical College and General Hospital, Nandyal, Kurnool Dist. Andhra Pradesh were obtained from Aug 2020 to Feb 2021, after receiving ethical approval from the Institutional Ethics Committee. The effects of the regimen are determined in terms of cure, finished treatment, treatment failure, number of patients moved to MDR-TB, number of patients who died in long-term MDR-TB regimen patients. Microsoft Excel 2007 was used to analyse the data. There were 82 male and 23 female out of 105 patients included in the study. Of these 75 patients were from rural areas and 40 from urban areas Using the Chi-square test and X2=12.1026, p=0.0005, which was important, the correlation between geographical spread and treatment result was determined. Out of 115 patients, 99 (86.09 percent) were cured of their disease, 06 (5.22 percent) died, 10 (8.69 percent) developed MDR-TB, and 2 (1.74 percent) were deemed medication errors. Males between the ages of 51 and 70 are more vulnerable to TB than females, according to our results. Compared to females of the same age, male patients over 40 years of age are more vulnerable to MDRTB. this was not part of the research objectives, emphasis should not be placed on this as either conclusion or recommendation.

Critical illness myopathy in intensive care setting

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mostafa K Fouad ◽  
Ashraf M Hazem ◽  
Kareem M Elnaghy
Keyword(s):  
Critical Illness ◽  
Mortality Rate ◽  
Usual Care ◽  
Usual Care Group ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Care Group ◽  
Fixed Effects Model ◽  
Analysis Study ◽  
Number Of Patients

Abstract Aim of the Work to provide cumulative data about the efficacy and safety of neuro-muscular electrical stimulation (NMES) combined with usual care (UC) versus usual care alone in ICU patients with Critical Illness Myopathy (CIM). Methodology The current systematic review was done on studies published between 2009 and 2019. The total number of patients in all the included studies was 1259 patients; 652 in NMES group, and 607 in UC group. Our data were divided into two groups: NMES (652 patients), and UC (607 patients). Metaanalysis study was done on 11 studies which described and compared the 2 different techniques for treatment of CIM; with overall number of patients (N = 1259). Results Regarding 1ry outcome measures, we found 8 studies reported critical Critical illness myopathy (CIM), critical illness polyneuropathy (CIP), and the overlap, critical care setting   MRC scale for muscle strength, with total number of patients (N = 968). The random-effects model of the meta-analysis study showed non-significant difference in mean MRC scale in NMES group compared to usual care group (p > 0.05). We also found 11 studies reported ICU stay with total number of patients (N = 1259). The random-effects model of the meta-analysis study showed nonsignificant difference in mean ICU stay in NMES group compared to usual care group (p > 0.05). We also found only 2 studies reported SF-36 scale for quality of life, with total number of patients (N = 270). The fixed-effects model of the metaanalysis study showed highly significant decrease in mean SF-36 scale in NMES group compared to usual care group (p = 0.003). Regarding 2ry outcome measure, we found 3 studies reported CIM incidence with total number of patients (N = 394). The fixed-effects model of the meta-analysis study showed marked decrease in CIM incidence in NMES group compared to usual care group, but not reaching statistical significance (p > 0.05). We also found 9 studies reported mortality rate with total number of patients (N = 1044). The fixed-effects model of the meta-analysis study showed non-significant difference in mortality rate in NMES group compared to usual care. Our systematic review and meta-analysis showed that NMES combined with usual care was not associated with significant differences in global muscle strength, ICU stay, quality of life score, CIM incidence and mortality rate in comparison with usual care alone in critically ill patients. Conclusion NMES is not superior to usual care in management of CIM. Usual care remains the mainstay of management of CIM with significant better outcomes, in addition to preventive measures as early aggressive treatment of sepsis and MOF, blood glucose control, optimizing certain drugs use, early enteral nutrition, maintaining water, electrolyte and acidbase balance.

scholarly journals Public Awareness regarding the Differences between Ophthalmologists and Optometrists among Saudi Adults Living in Riyadh: A Quantitative Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammed Hamad Aldebasi ◽  
Nasser Abdalazez Alsobaie ◽  
Abdulrahman Yousef Aldayel ◽  
Khalid Mousa Alwusaidi ◽  
Tariq Alasbali
Keyword(s):  
Saudi Arabia ◽  
Public Awareness ◽  
Multivariate Logistic Regression Analysis ◽  
Public Knowledge ◽  
Multivariate Logistic Regression ◽  
Eye Care ◽  
Online Questionnaire ◽  
Awareness Campaign ◽  
Care Services ◽  
Population Education

Awareness of the patients to the differences between ophthalmologists and optometrists has been recognized as an important factor influencing patient utilization of available eye care services. This study aimed at assessing the public’s knowledge of the differences between ophthalmologists and optometrists among the residents of Riyadh, Saudi Arabia. An online questionnaire was administered to adults in Riyadh, Saudi Arabia, from January to February in 2018. The number of the respondents was 1579. Results show that 50% (n=789) of the participants had fair knowledge of the differences between ophthalmologists and optometrists, while 32% (n=505) had poor knowledge. After multivariate logistic regression analysis, there was a significant association between satisfactory knowledge and visiting an optometrist (odds ratio (OR): 0.75, 95% CI: 0.57–0.98), age older than 26 (OR: 1.73, 95% CI: 1.17–1.19), higher level of education (OR: 1.92, 95% CI: 1.54–2.4), and wearing spectacles (OR: 0.57, 95% CI: 0.45–0.73). Given the low level of public knowledge regarding the differences in the duties between ophthalmologist and optometrists among a Saudi population, there is great potential for general population education through awareness campaign and social media regarding eye care provider’s duties and practices.

scholarly journals Association of patient-to-emergency department staff ratio with the incidence of cardiac arrest: A retrospective cohort study

2021 ◽  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Cohort Study ◽  
Length Of Stay ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Medical Center ◽  
Occupancy Rate ◽  
Number Of Patients ◽  
Ed Overcrowding

Background: Emergency department (ED) overcrowding and overuse are global healthcare problems. Despite that substantial pieces of literature have explored quality parameters to monitor the patients’ safety and quality of care in the ED, to the best of our knowledge, no reasonable patient-to-ED staff ratios were established. Objectives: This study aimed to find the association between unexpected emergency department cardiac arrest (EDCA) and the patient-to-ED staff ratio. Methods: A retrospective cohort study was conducted in a medical center in Taiwan. Non-trauma patients (age > 18) who visited the ED from January 1, 2016 to November 30, 2018 were included. The total number of patients in ED, number of patients waiting for boarding, length of stay over 48 hours, and physician/nurse number in ED were collected and analyzed. The primary outcome was the association of each parameter with the incidence of EDCA. Results: A total of 508 patients were included. The total number of patients in ED ( > 361, RR: 1.54; 95% CI {1.239-1.917}), ED occupancy rate (> 280, RR: 1.54; 95% CI {1.245-1.898}), ED bed occupancy rate (> 184, RR: 1.63; 95% CI {1.308-2.034}), number of patients waiting for boarding (> 134, RR: 1.45; 95% CI {1.164-1.805}), number of patients in ED with length of stay over 48 hours (> 36, RR: 1.27; 95% CI {1.029-1.558}) and patient-to-nurse ratio (> 8.5, adjusted RR: 1.33; 95% CI {1.054-1.672}) had significant associations with higher incidence of EDCA. However, the patient-to-physician ratio was not associated with EDCA incidence. Discussions: Regarding loading parameters, the patient-to-nurse ratio is more representative than the patient-to-physician ratio as regards association with higher EDCA incidence. Conclusions: A higher patient-to-nurse ratio (> 8.5) was associated with an increment in the incidence of EDCA. Our findings provide a basis for setting different thresholds for different ED settings to adjust ED staff and develop individually tailored approaches corresponding to the level of ED overcrowding.

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