ABSTRACT
Background Unintentional injuries are the leading preventable cause of mortality across different demographics. This study aims to assess the prevalence, severity, contributing factors, and clinical outcomes of unintentional injuries among adolescent patients. Methods A retrospective study was conducted using the charts of patients admitted with unintentional injuries (motor vehicle accidents (MVA), falls, pedestrian injuries, burns, etc.) to the emergency department (ED) from January 2016 to December 2018 at a level-one trauma center in Riyadh, Saudi Arabia. A total of 721 patients' charts were reviewed, but only 52 patients were consecutively included as per the definition of an adolescent. All variables, including severity and outcome, were assessed. Results The overall prevalence of unintentional injuries was 7.2 per 100 adolescent patients. The most common cause of unintentional injury were MVAs, which were reported in 35 (71%), with head and neck region injuries among 38 (73%) patients. The overall mortality was noted at 10 per 52 (19%) patients. The mean Injury Severity Score (ISS) score was 17.81±12.76. The patients who stayed longer in the ED were not associated with pelvic and lower extremity injuries, with a p-value=0.008. The ISS was the significant predictor of mortality, with an odds ratio (OR) of 1.6, a confidence interval (CI) of 1.02-2.65, and a p-value=0.04. Conclusion MVAs were the main cause of unintentional injuries among adolescents. Future recommendation plans for adolescents should include stricter implementation of road traffic laws to control this early, preventable death among adolescents.
ABSTRACT
Background Missed injuries are defined as injuries neither detected in the emergency department (ED) nor after admission to the hospital. The objective of this research was to identify missed injury rates, contributing factors, and clinical outcomes. Methods A total of 657 trauma patients' records were retrospectively reviewed after admission to King Abdulaziz Medical City (KAMC) during the period from January 2016 to December 2018. Patients' demographic characteristics, presence of a missed injury, and Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Injury Severity Score (ISS) were assessed. Results Among 657 patients who were admitted to our emergency department, only 11 (1.7%) patients were reported to have a missed injury during the hospital stay. None of those missed injuries contributed to the overall mortality. Higher GCS is a protective factor for missed injury with OR=0.12-0.81 and p-value=0.01. RTS and intensive care unit (ICU) stays were borderline although p-value=0.05 and OR=9 for RTS. Both longer ICU stays and high RTS were related to a higher risk of missed injury. Conclusion In our study, the prevalence of missed injuries was on the lower end of the spectrum in comparison to multiple published data. The most common missed injuries were fractures and joint dislocations of extremities. None of those missed injuries were life-threatening or contributed to overall mortality. Higher GCS was a protective factor against missed injuries while high RTS and longer ICU stays were related to a higher likelihood of developing missed injuries during the hospital course.
ABSTRACT
Background and objective Gastrostomy is a procedure that involves placing a feeding tube through the abdominal wall into the stomach to provide nutritional support. There are several modes of gastrostomy tube insertion including laparoscopic-assisted gastrostomy (LAG), percutaneous endoscopic gastrostomy (PEG), and open gastrostomy (OG) procedure, among others. Although it is a widely performed procedure, limited data is available regarding gastrostomy in Saudi Arabia, specifically among the pediatric population. This study aimed to shed more light on different aspects of surgical gastrostomy procedures among pediatric patients at the King Abdullah Specialist Children's Hospital (KASCH) in Riyadh, Saudi Arabia. The main objective of our study was to report the indications and complications of both LAG and OG insertions in the pediatric population. Methods A retrospective cross-sectional study was conducted at KASCH to analyze the different parameters related to LAG and OG insertions, and to evaluate for any association between these modes of insertion and their complications. Pertinent data on children from birth to 14 years of age were collected through consecutive sampling using a chart review. A total of 107 pediatric patients who underwent the procedure from 2016 to 2020 were evaluated. Results Demographically, the majority (58%) of gastrostomies were performed in infants (less than a year old). Additionally, our study showed a significantly increased association between LAG and complications such as discharge, (27.12%), skin manifestations (27.12%), and bleeding (10.17%) when compared to OG. Conclusion Based on our findings, LAG showed less favorable outcomes in contrast to OG. Further studies should be conducted to validate our findings and ensure consistent results and outcomes among different methods of gastrostomy tube insertion.
