24 research outputs found
Clinical profile, management, and outcome in patients with out of hospital cardiac arrest: insights from a 20-year registry
Ashfaq Ahmad Patel, Abdul Rahman Arabi, Hakam Alzaeem, Jassim Al Suwaidi, Rajvir Singh, Hajar A Al BinaliDepartment of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, QatarBackground: There is limited information regarding the clinical characteristics and outcome of out of hospital cardiac arrest (OHCA) in Middle Eastern patients. The aim of this study was to evaluate clinical characteristics, treatment, and outcomes in patients admitted following OHCA at a single center in the Middle East over a 20-year period.Methods: The data used for this hospital-based study were collected for patients hospitalized with OHCA in Doha, Qatar, between 1991 and 2010. Baseline clinical characteristics, in-hospital treatment, and outcomes were studied in comparison with the rest of the admissions.Results: A total of 41,453 consecutive patients were admitted during the study period, of whom 987 (2.4%) had a diagnosis of OHCA. Their average age was 57±15 years, and 72.7% were males, 56.5% were Arabs, and 30.9% were South Asians. When compared with the rest of the admissions taken as a reference, patients with OHCA were more likely to have diabetes mellitus (42.8% versus 39.1%, respectively, P=0.02), prior myocardial infarction (21.8% versus 19.2%, P=0.04), and chronic renal failure (7.4% versus 3.9%, P=0.001), but were less likely to have dyslipidemia (16.9% versus 25.4%, P=0.001). Further, 52.6% of patients had preceding symptoms, the most common of which was chest pain (27.2%) followed by dyspnea (24.8%). An initially shockable rhythm (ventricular fibrillation or ventricular tachycardia) was present in 25.1% of OHCA patients, with ST segment elevation myocardial infarction documented in 30.0%. Severely reduced left ventricular systolic function (ejection fraction ≤35%) was present in 53.2% of OHCA patients; 42.9% had cardiogenic shock requiring use of inotropes at presentation. An intra-aortic balloon pump was inserted in 3.6% of cases. Antiarrhythmic medications were used in 27.4% and thrombolytic therapy in 13.9%, and 10.8% underwent a percutaneous coronary procedure (coronary angiography ± percutaneous coronary intervention). The in-hospital mortality rate was 59.8%.Conclusion: OHCA was associated with higher incidences of diabetes, prior myocardial infarction, and chronic kidney disease as compared with the remaining admissions. Approximately half of the patients had no preceding symptoms. In-hospital mortality was high (59.8%), but similar to the internationally published data.Keywords: out of hospital cardiac arrest, cardiogenic shock, in-hospital mortalit
Drowning in children: Aseer Central Hospital experience, Southwestern Saudi Arabia
Aim: To study the reasons, magnitude and outcome of drowning following submersion in water of children admitted to the Pediatric Intensive Care Unit in Aseer Province, Saudi Arabia. Materials and Methods: A retrospective cohort study of all pediatric patients (0-13) years old who drowned and were admitted to the Pediatric Intensive Care Unit, Aseer Central Hospital, Southwestern Saudi Arabia, between January 1st 1999 and December 31st 2009. Results: A total of 19 cases were admitted following submersion in water. The mean age was 5.2 years ±3.8. Majority of victims (94.1%) were from the highland areas. Events most frequently occurred in the summer (46.7%), followed by spring and winter, 33.3% and 20%, respectively. Home events constituted 44.4% of submersion cases. Of these, 55.6% drowned in a washing container, While 53.4% submersed in swimming pools. Twenty-two percent of these accidents occurred in the sea and in wells while 11.1% occurred in a lake. The mean duration of submersion was 4.04 minutes ± 5.35. Cardiac arrest was reported upon arrival at hospital in 42.1% of the victims. There were seven deaths (36.8 %) and in one patient (5.2 %) there was severe brain injury. In all deceased cases, no adults were watching the children when the accidents occurred. Conclusion: Drowning is a significant risk factor facing our children and can claim lives. The media as well as the authority should play a major role in increasing the public awareness to minimize or prevent such a problem
Original Article - Does the circadian pattern for acute cardiac events presentation vary with fasting?
Background: Over one billion Muslims fast worldwide during the month of
Ramadan. The impact of fasting on circadian presentation with acute
cardiac events is unknown. Aim: To determine if fasting has any effect
on the circadian presentation of acute cardiac events. Setting and
Design: A prospective study in a general hospital. Materials and
Methods: Patients with acute coronary events were divided into two
groups based on the history of fasting. Information about age, gender,
cardiovascular risk factor profiles, and outcome was collected. The
relationship of time of presentation of initial symptoms with fasting
was evaluated using Student′s t-test, Mann-Whitney U-test, and
x2sub analysis. Results: Of the 1019 patients hospitalized during the
study period, 162 were fasting. Although, fasting patients were more
likely to present to the emergency department in the time periods 5-6
AM (10.5% vs 6.3%) and 11 PM (11.1% vs 7.1%) and were less likely to
present in the time periods 1-2 PM (3.7% vs 7.2%) and 5-6 PM (3.7% vs
7.0%); these differences were not statistically significant. Fasting
patients were less likely to have their symptoms start between 5 and 8
AM (11.1% vs 19.4%) and more likely to have symptoms between 5 and 6
PM (11.1% vs 6.0%) and 3 and 4 AM (11.1% vs 6.9%). These differences
for time of initial symptoms were statistically significant (P=0.002).
Conclusion: Exogenous factors associated with fasting, namely, the
changes in food intake and/or sleep timings, affect the circadian
rhythm and influence the timing of presentation of acute coronary
events
Impact of fasting in Ramadan in patients with cardiac disease
Objectives: To investigate whether Ramadan fasting has any effect on patients with heart disease