ABSTRACT
Objectives: To evaluate the impact of weekend admission on the outcome of patients with acute variceal hemorrhage [AVH] Design: Retrospective study Setting: Department of Surgery, College of Medicine, King Saud University, KSA Main Outcome Measures: AVH, weekend admission and clinical outcome
Subjects: Nine hundred and thirty-seven admitted during the period 1[st] January 2005 to 31[st] July 2013 and documented to have AVH. The selected patients were divided into two groups based on the admission day [weekday or weekend admission]. The data regarding patients characteristics and outcome in both the groups were retrieved from medical records and compared by using c2 test / Fisher's exact and student T- test
Results: Weekday admissions included 685 patients, while the weekend group comprised of 252 patients. The demographic, clinical and laboratory characteristics of patients admitted with AVH in both the groups were comparable. Statistically, there was no significant difference in the need for blood transfusion [46% versus 48%, p = 0.5868], and surgical intervention [5.4% versus 4.7%; p = 0.6595] between the groups. There was a little, but statistically significant delay in endoscopic intervention in the weekend group [7.56 +/- 7.8 hours versus 9 +/- 2.32; p = < 0.0001]. However, this delay did not lead to adverse outcome for patients [mortality rate 6.8% versus 5.25%; p = 0.389]
Conclusions: The weekend admissions were not associated with increased mortality in patients with AVH. Moreover, the length of hospital stay, need for blood transfusion, and rate of surgical intervention were similar in weekdays and weekend admissions
ABSTRACT
To determine the role of postoperative antibiotics in reducing the surgical site infections [SSIs] after open appendectomy in patients with non-perforated appendicitis [NPA]. Randomized controlled trial. The Department of Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia, from January 2010 to July 2011. Three hundred and seventy seven patients, who underwent appendectomy for NPA and fulfilled the selection criteria, were randomized into two groups. The patients in group A received a single dose of pre-operative antibiotics [cefuroxime sodium and metronidazole], while the group B patients received one more dose of the same antibiotics postoperatively. Patients of both the groups were followed-up for 30 days to assess the postoperative infective complications. Group A had 195, while group B comprised of 182 patients. The groups were comparable in the baseline characteristics. Statistically there was no significant difference in rates of SSIs between both the groups [p = 0.9182]. Mean hospital stay was 2.29 +/- 0.81 and 2.35 +/- 0.48 days for group A and B respectively [p = 0.4403]. None of the patients developed intraabdominal collection. Single dose of pre-operative antibiotics [cefuroxime and metronidazole] was sufficient in reducing the SSIs after appendectomy for NPA. Postoperative antibiotics did not add an appreciable clinical benefit in these patients