Trauma profile at a tertiary intensive care unit in Saudi Arabia

Trauma is a leading cause of death worldwide and in Saudi Arabia. This study describes the injury profiles and ICU outcomes of patients in a tertiary trauma care referral center in Riyadh, Saudi Arabia. A retrospective analysis of ICU data collected prospectively over 5 years in a 21-bed medical and surgical intensive care unit [ICU] in a tertiary care teaching hospital. We collected ICU data on all patients admitted secondary to motor vehicle accidents [MVAs], excluding patients younger than 18 years, brain dead patients and readmissions. We collected data on age, gender, and Glasgow coma scale score at admission, injury severity scores at admission, injury severity scores, Acute Physiology and Chronic Health Evaluation II [APACHE II] score, and other data. Multivariate logistic regression was used to identify predictors of mortality. During the study period, of 1659 patients, MVA was the most common cause of injury [78.4%], followed by pedestrian accident [12.7%]. ICU mortality included 221 patients [13.3%] during the study period. Severe head injury, age >60 years, Glascow coma scale score, injury severity scores, APACHE II and international normalized ratio were independent predictors of mortality. MVA is very common in our country and leads to significant mortality and morbidity. Public education and strict law enforcement are needed to reduce these adverse events

-hospital mortality among a cohort of cirrhotic patients admitted to a Tertiary hospital

To determine the mortality rate in a cohort of hospitalized patients with cirrhosis and examine their resuscitation status at admission. A retrospective chart review was conducted of patients with cirrhosis who were admitted to a tertiary care hospital in Riyadh, Saudi Arabia, from January 1, 2009, to December 31, 2009. We reviewed 226 cirrhotic patients during the study period. The hospital mortality rate was 35%. A univariate analysis revealed that worse outcomes were seen in patients with advanced age or who had worse child-turcotte-pugh [CPT] scores, worse model for end-stage liver disease [MELD] scores, low albumin and high serum creatinine. Using a multivariate analysis, we found that advanced age [P=0.004] and high MELD [P=0.001] scores were independent risk factors for the mortality of cirrhotic patients. The end-of-life decision were made in 34% of cirrhotic patients, and the majority of deceased patients were "no resuscitation" status [90% vs. 4%, P<0.001]. The relatively high mortality in cirrhotic patients admitted for care in a tertiary hospital, Saudi Arabia was comparable to that reported in the literature. Furthermore, end-of-life discussions should be addressed early in the hospitalization of cirrhotic patients

Intensive insulin therapy versus conventional insulin therapy for critically ill trauma patients admitted to ICU

The objective of our study was to evaluate the beneficial effect of IIT in reducing mortality and morbidity in critically ill trauma patients admitted to ICU. Nested cohort study within a Randomized Controlled Trial. All trauma patients with GCS