ABSTRACT
BACKGROUND: Acute kidney injury (AKI) is a common serious problem affecting critically ill patients in intensive care unit (ICU). It increases their morbidity, mortality, length of ICU stay, and long-term risk of chronic kidney disease (CKD). METHODS: A retrospective study was carried out in a tertiary hospital in Jordan. Medical records of patients admitted to the medical ICU between 2013 and 2015 were reviewed. We aimed to identify the incidence, risk factors, and outcomes of AKI. Acute kidney injury network (AKIN) classification was used to define and stage AKI. RESULTS: 2530 patients were admitted to medical ICU, and the incidence of AKI was 31.6%, mainly in stage 1 (59.4%). In multivariate analysis, increasing age (odds ratio (OR) = 1.2 (95% CI 1.1-1.3), P = 0.0001) and higher APACHE II score (OR = 1.5 (95% CI 1.2-1.7), P = 0.001) were predictors of AKI, with 20.4% of patients started on hemodialysis. At the time of discharge, 58% of patients with AKI died compared to 51.3% of patients without AKI (P = 0.05). 88% of patients with AKIN 3 died by the time of discharge compared to patients with AKIN 2 and 1 (75.3% and 61.2% respectively, P = 0.001). CONCLUSION: AKI is common in ICU patients, and it increases mortality and morbidity. Close attention for earlier detection and addressing risk factors for AKI is needed to decrease incidence, complications, and mortality.
ABSTRACT
BACKGROUND: Headscarf pin aspiration is a common and unique form of foreign body aspiration among young Moslem women. Rigid bronchoscopy (RB) is considered the standard procedure for retrieval. There are little data on the role of flexible fiberoptic bronchoscopy (FOB) in the retrieval of aspirated headscarf pins. OBJECTIVES: The aim of this study is to prospectively evaluate the utility of FOB for the retrieval of aspirated headscarf pins. METHODS: Patients with the diagnosis of headscarf pin aspiration admitted to King Abdullah University Hospital from December 2002 to December 2005 were included in the study. Standard FOB procedure under local anesthesia and conscious sedation was performed as the primary tool for retrieval. RESULTS: A total of 16 cases was admitted during the study period. The mean age was 19 years. The aspirated pin was successfully retrieved in 9/16 cases (56%) during the first attempt of FOB. In another 3 cases, although the pin was successfully retrieved from the bronchial tree, it was lost in the throat and swallowed, and then recovered by esophagogastroduodenoscopy. However, FOB was not successful in 4/16 cases. In 3 cases, the aspirated pins were successfully retrieved by RB under general anesthesia and the fourth case required thoracotomy. CONCLUSIONS: Headscarf pin aspiration is a relatively common form of foreign body aspiration among young Moslem Jordanian women. FOB under local anesthesia can be a useful first-step tool in retrieval, provided facilities for esophagogastroduodenoscopy and RB are readily available.
