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1.
Cureus ; 16(9): e69338, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39398650

ABSTRACT

OBJECTIVE: Ultrasound training in undergraduate medical education is developing, and its incorporation into the curriculum requires careful planning. Extended Focused Assessment Sonography for Trauma (EFAST) is commonly taught to medical students as one of the primary applications of ultrasound. Because false-negative EFAST scans can affect patients' clinical outcomes, it is essential to evaluate the individual components of this skill. We aim to determine which EFAST components students perform sub-optimally after initial training. METHODS: In this prospective observational study, 90 medical students from two final-year cohorts were assessed in EFAST components after uniform training during the emergency medicine clerkship. All validated components of the standard EFAST exam were assessed, and a descriptive analysis of individual components of EFAST was performed. RESULTS: The hepatorenal space, splenorenal space, and pelvic space fluid investigations had the lowest completion rates. Pericardial fluid, pelvic free fluid, and right thoracic pleural fluid investigations were often incorrectly applied. Fanning was most commonly missed in hepatorenal, splenorenal, and pelvic free fluid investigations, and between 12% and 50% of EFAST components had omitted reporting. CONCLUSIONS: There were significant incomplete assessments for free intraperitoneal fluid, primarily due to a lack of fanning in the hepatorenal, splenorenal, and pelvic areas. Trainers can effectively enhance student performance and outcomes by targeting these challenging areas. Further research might reveal whether residents and physicians show similar trends in EFAST completion.

2.
Int J Emerg Med ; 17(1): 86, 2024 Jul 11.
Article in English | MEDLINE | ID: mdl-38992598

ABSTRACT

BACKGROUND AND AIM: In-hospital cardiac arrest (IHCA) is a major cause of mortality globally, and over 50% of the survivors will require institutional care as a result of poor neurological outcome. It is important that physicians discuss the likely outcome of resuscitation with patients and families during end-of-life discussions to help them with decisions about cardiopulmonary resuscitation. We aim to compare three consultants' do-not-resuscitate (DNR) decisions with the GO-FAR score predictions of the probability of survival with good neurological outcomes following in-hospital cardiac arrest (IHCA). METHODS: This is a retrospective study of all patients 18 years or older placed on a DNR order by a consensus of three consultants in a tertiary institution in the United Arab Emirates over 12 months. Patients' socio-demographics and the GO-FAR variables were abstracted from the electronic medical records. We applied the GO-FAR score and the probability of survival with good neurological outcomes for each patient. RESULTS: A total of 788 patients received a DNR order, with a median age of 71 years and a majority being males and expatriates. The GO-FAR model categorized 441 (56%) of the patients as having a low or very low probability of survival and 347 (44%) as average or above. There were 219 patients with a primary diagnosis of cancer, of whom 148 (67.6%) were in the average and above-average probability groups. There were more In-hospital deaths among patients in the average and above-average probability of survival group compared with those with very low and low probability (243 (70%) versus 249 (56.5%) (P < 0.0001)). The DNR patients with an average or above average chance of survival by GO-FAR score were more likely to be expatriates, oncology patients, and did not have sepsis. CONCLUSIONS: The GO-FAR score provides a guide for joint decision-making on the possible outcomes of CPR in the event of IHCA. The physicians' recommendation and the ultimate patient's resuscitation choice may differ due to more complex contextual medico-social factors.

3.
Libyan J Med ; 19(1): 2321671, 2024 Dec 31.
Article in English | MEDLINE | ID: mdl-38404044

ABSTRACT

We aim to study the characteristics and outcomes of patients with a Do-Not-Attempt Resuscitation and to determine its impact on the Cost of In-Hospital Cardiac Arrest. A retrospective study of all adult patients admitted to the hospital from June 2021 to May 2022 who had a Do-Not-Resuscitate order. We abstracted patients' socio-demographics, physiologic parameters, primary diagnosis, and comorbidities from the electronic medical records. We calculated the potential economic cost using the median ICU length of stay for the admitted IHCA patients during the study period. There were 28,866 acute admissions over the study period, and 788 patients had DNR orders. The median (IQR) age was 71 (55-82) years, and 50.3% were males. The most prevalent primary diagnosis was sepsis, 426 (54.3%), and cancer was the most common comorbidity. More than one comorbidities were present in 642 (80%) of the cohort. Of the DNR patients, 492 (62.4%) died, while 296 (37.6%) survived to discharge. Cancer was the primary diagnosis in 65 (22.2%) of those who survived, compared with 154 (31.3%) of those who died (P = 0.002). Over the study period, 153 patients had IHCA and underwent CPR, with an IHCA rate of 5.3 per 1,000 hospital admissions. Without a DNR policy, an additional 492 patients with cardiac arrest would have had CPR, resulting in an IHCA rate of 22.3 per 1000 hospital admissions. Most DNR patients in our setting had sepsis complicated by multiple comorbidities. The DNR policy reduced our IHCA incidence by 76% and prevented unnecessary post-resuscitation ICU care.


Subject(s)
Heart Arrest , Neoplasms , Sepsis , Male , Adult , Humans , Aged , Aged, 80 and over , Female , Resuscitation Orders , Retrospective Studies , Developing Countries , Heart Arrest/epidemiology , Heart Arrest/therapy , Hospitals
4.
World J Surg ; 48(4): 863-870, 2024 04.
Article in English | MEDLINE | ID: mdl-38381056

ABSTRACT

AIM: To study the preventable trauma deaths of hospitalized patients in the United Arab Emirates and to identify opportunities for improvement. METHODS: We analyzed the Abu Dhabi Emirate Trauma Registry data of admitted patients who died in the emergency department or in hospital from 2014 to 2019. A panel of experts categorize the deaths into not preventable (NP), potentially preventable (PP), and definitely preventable (DP). RESULTS: A total of 405 deaths were included, and 82.7% were males. The majority (89.1%) were NP, occurring mainly in the emergency department (40.4%) and the intensive care unit (49.9%). The combined potentially preventable and preventable death rate was 10.9%. The median (Interquartile range) age of the DP was 57.5 (37-76) years, compared with 32 (24-42) and 34 (25-55) years for NP and PP, respectively (p = 0.008). Most of the PP deaths occurred in the intensive care unit (55.6%), while the DP occurred mainly in the ward (50%). Falls accounted for 25% of PP and DP. Deficiencies in airway care, hemorrhage control, and fluid management were identified in 25%, 43.2% and 29.5% of the DP/PP deaths, respectively. Seventy-two percent of the Airway deficiencies occurred in the prehospital, while 34.1% of hemorrhage control deficiencies were in the emergency department. Fluid management deficiencies occurred in the emergency department and the operation theater. CONCLUSIONS: DP and PP deaths comprised 10.9% of the deaths. Most of the DP occurred in the emergency department and ward. Prehospital Airway and in-hospital hemorrhage and excessive fluid were the main areas for opportunities for improvement.


Subject(s)
Heart Failure , Wounds and Injuries , Male , Humans , Middle Aged , Aged , Female , Hemorrhage , Emergency Service, Hospital , Hospitals , Hospitalization , Wounds and Injuries/therapy , Cause of Death , Trauma Centers , Retrospective Studies
5.
World J Emerg Surg ; 18(1): 31, 2023 04 28.
Article in English | MEDLINE | ID: mdl-37118764

ABSTRACT

AIM: To study the epidemiology and pattern of trauma-related deaths of hospitalized patients in Abu Dhabi Emirate, United Arab Emirates, in order to improve trauma management and injury prevention. METHODS: The Abu Dhabi Trauma Registry prospectively collects data of all hospitalized trauma patients from seven major trauma centres in Abu Dhabi Emirate. We studied all patients who died on arrival or after admission to these hospitals from January 2014 to December 2019. RESULTS: There were 453 deaths constituting 13.5% of all trauma deaths in the Abu Dhabi Emirate. The median (IQR) age of the patients was 33 (25-45) years, and 82% were males. 85% of the deaths occurred in the emergency department (ED) and the intensive care unit (ICU). Motor vehicle collision (63.8%) was the leading cause of death. 45.5% of the patients had head injury. Two of the seven hospitals admitted around 50% of all patients but accounted for only 25.8% of the total deaths (p < 0.001). Those who died in the ward (7%) were significantly older, median (IQR) age: of 65.5 (31.75-82.25) years, (p < 0.001), 34.4% of them were females (p = 0.09). The median (IQR) GCS of those who died in the ward was 15 (5.75-15) compared with 3 (3-3) for those who died in ED and ICU (P < 0.001). CONCLUSIONS: Death from trauma predominantly affects young males with motor traffic collision as the leading cause. Over 85% of in-hospital deaths occur in the ICU and ED, mainly from head injuries. Injury prevention of traffic collisions through enforcement of law and improved hospital care in the ED and ICU will reduce trauma death.


Subject(s)
Accidents, Traffic , Craniocerebral Trauma , Male , Female , Humans , Aged , Aged, 80 and over , Adult , Middle Aged , United Arab Emirates/epidemiology , Retrospective Studies , Hospitalization , Intensive Care Units , Craniocerebral Trauma/epidemiology
6.
J Med Case Rep ; 17(1): 95, 2023 Mar 16.
Article in English | MEDLINE | ID: mdl-36922869

ABSTRACT

BACKGROUND: Dettol and sodium hypochlorite have wide use as household disinfectants and cleaners. Intentional and nonintentional ingestion are widespread, mainly causing mild symptoms that require no specific treatment. However, severe complications can occur when large volumes are ingested. Both products affect the same organ systems in the body, which can result in fatalities when ingested together. CASE PRESENTATION: We present the case of a 26-year-old Asian man who died from multiorgan failure after deliberately ingesting a presumed large volume of Dettol and sodium hypochlorite. The case illustrates the severe complications that can occur with mixed ingestion of these commonly used household products. CONCLUSION: Clinicians must be aware of the increased risk of death caused by the combined ingestion of chloroxylenol and sodium hypochlorite.


Subject(s)
Disinfectants , Sodium Hypochlorite , Male , Humans , Adult , Xylenes
7.
World J Emerg Surg ; 18(1): 25, 2023 03 29.
Article in English | MEDLINE | ID: mdl-36991466

ABSTRACT

BACKGROUND: In the last two decades, there have been major improvements in the trauma system in the United Arab Emirates (UAE). We aimed to study the changes in the incidence, type, severity, and outcome of trauma of hospitalized child-bearing age women in Al-Ain City, UAE, during that time. METHODS: Data from two separate trauma registries of Al-Ain Hospital, which were prospectively collected from March 2003 to March 2006 and January 2014 to December 2017, were analyzed retrospectively. All women aged 15-49 years were studied. The two periods were compared. RESULTS: Trauma incidence of hospitalized child-bearing age women was reduced by 47% during the second period. There were no significant differences in the mechanism of injury between the two periods. Road traffic collision was the main cause of injury (44% and 42%, respectively) followed by fall down (26.1% and 30.8%, respectively). The location of injury was significantly different (p = 0.018), with a strong trend of more home injuries in the second period (52.8% compared with 44%, p = 0.06). There was a strong statistical trend of mild traumatic brain injury (GCS 13-15) in the second period (p = 0.067, Fisher's Exact test). Those who had normal GCS of 15 were significantly higher in the second period compared with those in the first period (95.3% compared with 86.4%, p < 0.001, Fisher's Exact test) despite having more anatomical injury severity of the head (AIS 2 (1-5) compared with 1 (1-5), p = 0.025). The NISS was significantly higher in the second period (median (range) NISS 5 (1-45) compared with 4 (1-75), p = 0.02). Despite that, mortality was the same (1.6% compared with 1.7%, p = 0.99) while the length of hospital stay was significantly less (mean (SD) 5.6 (6.3) days compared with 10.6 (13.6) days, p < 0.0001). CONCLUSIONS: The incidence of trauma in hospitalized child-bearing-age women was reduced by 47% over the last 15 years. Road traffic collisions and falls are the leading cause of injury in our setting. Home injuries increased over time. The mortality remained stable despite the increased severity of injured patients. More injury prevention efforts should target home injuries.


Subject(s)
Accidents, Traffic , Hospitalization , Humans , Female , Retrospective Studies , Hospital Mortality , Length of Stay
8.
Eur J Trauma Emerg Surg ; 49(2): 837-842, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36335514

ABSTRACT

AIM: To evaluate the value of the individual components of GCS in predicting the survival of trauma patients in the Emergency Department. METHODS: Trauma patients who were admitted for more than 24 h or died after arrival at Al-Ain Hospital from January 2014 to December 2017 were studied. Children < 16 years, elderly > 80 years, patients with facial injuries, those intubated in the ER, and those with missing primary outcomes were excluded. Demography, vital signs, Glasgow Coma Scale (GCS), GCS components, Injury Severity Score (ISS), head AIS, and death were compared between those who died and those who survived. Factors with a p value of < 0.1 were entered into a backward likelihood logistic regression model to define factors that predict death. RESULTS: A total of 2548 patients were studied, out of whom 11 (0.4%) died. The verbal component of GCS (p < 0.001) and the ISS (p = 0.047) were the only significant predictors for death in the logistic regression model. The AUC (95% CI) of the GCS-VR was 0.763 (0.58-0.95), p = 0.003. The best point of GCS-VR that predicted survival was 5, having a sensitivity of 97%, a specificity of 54.5%, positive predictive value of 99. 8%, negative predictive value of 7.3%, and likelihood ratio of 2.13. CONCLUSION: In general trauma patients, acute trauma care professionals can use GCS-VR to predict survival when clinical condition permits instead of the total GCS score or ISS.


Subject(s)
Critical Care , Emergency Service, Hospital , Child , Humans , Aged , Glasgow Coma Scale , Injury Severity Score , Predictive Value of Tests , Retrospective Studies
9.
J Med Case Rep ; 16(1): 475, 2022 Dec 16.
Article in English | MEDLINE | ID: mdl-36527121

ABSTRACT

BACKGROUND: Patients with underlying cardiovascular risk factors have worse clinical outcomes when they have coronavirus disease. In addition, a reduced workload of cardiovascular emergencies has been reported during the coronavirus pandemic due to patients' reluctance to attend hospitals for fear of contracting the disease. Regional health service reorganization, separating hospitals into coronavirus and non-coronavirus can mitigate this effect. However, the effectiveness of this approach on outcomes and patient satisfaction is unknown. CASE PRESENTATION: A 35-year-old Pakistani man with acute ST myocardial infarction was found to have thrombosis of the right coronary artery aneurysm and concomitant coronavirus disease. He had percutaneous coronary angiography and thrombus removal, and was transferred to a coronavirus hospital for the management of the infection. Due to the large size of the aneurysm, he was considered for surgical intervention. Following discharge from the coronavirus hospital and a period of stay at the isolation center, he failed to keep his cardiology follow-up appointment. CONCLUSION: This case illustrates an unusual cause of myocardial infarction in a patient with coronavirus infection whose care may have been adversely affected by the healthcare system restructuring.


Subject(s)
COVID-19 , Coronary Aneurysm , Myocardial Infarction , Percutaneous Coronary Intervention , ST Elevation Myocardial Infarction , Thrombosis , Male , Humans , Adult , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/etiology , ST Elevation Myocardial Infarction/therapy , COVID-19/complications , Coronary Vessels , Percutaneous Coronary Intervention/adverse effects , Myocardial Infarction/complications , Thrombosis/complications
10.
PLoS One ; 17(11): e0278381, 2022.
Article in English | MEDLINE | ID: mdl-36445878

ABSTRACT

BACKGROUND: Facial injuries affect one-third of severely injured patients. These injuries have devastating long-term negative impacts on quality of life. We aimed to study the epidemiology of facial injuries and factors affecting the mortality of hospitalized facial trauma patients in Al-Ain City, United Arab Emirates. METHODOLOGY: This is a retrospective analysis of prospectively collected data from Al-Ain Hospital Trauma Registry. All patients with facial injury who were hospitalized for more than 24 hours or who died after arrival at the hospital during the period from January 2014 to December 2017 were studied. Two sample data analysis was used to compare patients who died and those who survived. Significant factors were then entered into a backward logistic regression model to define factors affecting mortality. RESULTS: 408 patients having a mean age of 31.9 years were studied, 87.3% were males. The main mechanisms of injury were road traffic collisions (52.2%) and fall from height (11.3%). 289 (70.8%) patients had associated injuries which were mainly in the head and chest. The backward logistic regression model showed that the Glasgow Coma Scale (GCS) was the only factor that predicted mortality, p<0.0001 with the best cut-off point of 7.5, having a sensitivity of 0.972 and a specificity of 0.8. The ROC had an area under the curve of 0.924. CONCLUSION: The majority of facial injury patients in our setting are young males who were involved in road traffic collisions or falls from height. The most important factor predicting the mortality of these patients was the low GCS. Those having a GCS of 8 and more had a better chance of survival. This information is very important when counseling patients or their relatives for facial surgery.


Subject(s)
Facial Injuries , Quality of Life , Male , Humans , Adult , Female , Retrospective Studies , United Arab Emirates/epidemiology , Facial Injuries/epidemiology , Patients , Death
13.
World J Emerg Surg ; 17(1): 21, 2022 04 29.
Article in English | MEDLINE | ID: mdl-35488275

ABSTRACT

BACKGROUND: There have been major improvements in the trauma system and injury prevention in Al-Ain City. We aimed to study the impact of these changes on the incidence, pattern, injury severity, and outcome of hospitalized motorcycle-related injured patients in Al-Ain City, United Arab Emirates. METHODS: This is a retrospective analysis of two separate periods of prospectively collected data which were retrieved from Al-Ain Hospital Trauma Registry (March 2003 to March 2006 compared with January 2014 to December 2017). All motorcycle-injured patients who were admitted to Al-Ain Hospital for more than 24 h or died in the Emergency Department or after hospitalization were studied. RESULTS: The incidence of motorcycle injuries dropped by 37.1% over the studied period. The location of injury was significantly different between the two periods (p = 0.02, Fisher's exact test), with fewer injuries occurring at streets/highways in the second period (69.1% compared with 85.3%). The anatomical injury severity of the head significantly increased over time (p = 0.03), while GCS on arrival significantly improved (p < 0.0001), indicating improvements in both prehospital and in-hospital trauma care. The mortality of the patients significantly decreased (0% compared with 6%, p = 0.002, Fisher's exact test). CONCLUSIONS: The incidence of motorcycle injuries in our city dropped by almost 40% over the last 15 years. There was a significant reduction in the mortality of hospitalized motorcycle-injured patients despite increased anatomical severity of the head injuries. This is attributed to improvements in the trauma care system, including injury prevention, and both prehospital and in-hospital trauma care.


Subject(s)
Craniocerebral Trauma , Motorcycles , Accidents, Traffic , Developing Countries , Humans , Retrospective Studies
14.
Resusc Plus ; 10: 100220, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35330757

ABSTRACT

Aim: In-Hospital Cardiac Arrest (IHCA) is a significant burden on healthcare worldwide. Outcomes of IHCA are worse in developing countries compared with developed ones. We aimed to study the epidemiology and factors determining outcomes in adult IHCA in a high income developing country. Methods: We abstracted prospectively collected data of adult patients admitted to our institution over a three-year period who suffered a cardiac arrest. We analysed patient demographics, arrest characteristics, including response time, initial rhythm and code duration. Pre-arrest vital signs, primary diagnoses, discharge and functional status, were obtained from the patients' electronic medical records. Results: A total of 447 patients were studied. The IHCA rate was 8.6/1000 hospital admissions. Forty percent (40%) achieved ROSC with an overall survival to discharge rate of 10.8%, of which 59% had a good functional outcome, with a cerebral performance category score of 1 or 2. Fifty-four percent (54%) of patients had IHCA attributed to causes other than cardiac or respiratory. Admission Glasgow Coma Scale (GCS), shockable rhythm and short code duration were significantly associated with survival (p < 0.001). Conclusion: A combination of patient and system-related factors, such as the underlying cause of cardiac arrest and a lack of DNAR policy, may explain the reduced survival rate in our setting compared with developed countries.

15.
Eur J Trauma Emerg Surg ; 48(4): 3011-3016, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35178582

ABSTRACT

AIM: We aimed to study the impact of the COVID-19 pandemic on the pattern of injury and outcome of hospitalized trauma patients in Al-Ain City, United Arab Emirates, to use this information in the preparedness for future pandemics. METHODS: We retrospectively compared the trauma registry data of all hospitalised trauma patients, who were treated at the two main trauma centres in Al-Ain City (Al-Ain Hospital and Tawam Hospital); those who were treated over 1 year before the pandemic (n = 2002) and those who were treated at the first year of the COVID-19 pandemic (n = 1468). RESULTS: There was a 26.7% reduction in the overall incidence of trauma admissions in the COVID-19 pandemic period. The mechanism of injury significantly differed between the two periods (p < 0.0001, Fisher's exact test). There was an absolute increase in the number of injuries, due to machinery and falling objects during the pandemic (39.7% and 54.1% respectively, p < 0.001). In contrast, road traffic collisions and falls were reduced by 33.5% and 31.3%, respectively. Location significantly differed between the two periods (p < 0.0001, Fisher's exact test). There was an absolute increase of 18.4% in workplace injuries and a reduction of 39.3% in home injuries over the study period. In addition, we observed relatively more workplace injuries and fewer home injuries during the pandemic (11.3% and 42.8% compared with 7.1% and 52.4%, respectively). Mortality was similar between the two periods (1.8% compared with 1.2%, p = 0.16, Fisher's exact test). CONCLUSIONS: The COVID-19 pandemic has modified the trauma risk exposure in our population. It reduced trauma hospital admissions by around 27%. Work-related injuries, including falling objects and machinery injuries, were relatively higher during the pandemic. Prevention of work-related injuries should be an important component of preparedness for future pandemics.


Subject(s)
COVID-19 , Occupational Injuries , Wounds and Injuries , COVID-19/epidemiology , Humans , Incidence , Occupational Injuries/epidemiology , Pandemics , Retrospective Studies , United Arab Emirates/epidemiology , Wounds and Injuries/epidemiology , Wounds and Injuries/therapy
16.
Int J Emerg Med ; 15(1): 4, 2022 Jan 22.
Article in English | MEDLINE | ID: mdl-35065608

ABSTRACT

BACKGROUND: Undergraduate emergency medicine (EM) training is important because all medical graduates are expected to have basic emergency knowledge and skills regardless of their future speciality. EM clerkship should provide opportunities to improve not only knowledge and skills but also the self-efficacy of learners. This study aims to evaluate the expectations, opinions, and self-efficacy beliefs of medical students during a 4-week mandatory EM clerkship. METHODS: This study used a prospective longitudinal design with quantitative and qualitative survey methods. It includes final year medical students of the 2015-2016 academic year. Voluntary de-identified pre- and post-clerkship surveys included 25 statements. The post-clerkship survey included two open-ended questions asking participants to identify the best and worst three aspects of EM clerkship. Responses were analysed to determine themes or commonalities in participant comments indicative of the EM clerkship learning experiences and environment. RESULTS: Sixty-seven out of seventy-nine (85%) students responded to both pre- and post-clerkship surveys. Medical students' expectations of EM clerkships' effect on knowledge and skill acquisition were high, and a 4-week mandatory EM clerkship was able to meet their expectations. Medical students had very high expectations of EM clerkships' educational environment. In most aspects, their experiences significantly exceeded their expectations (p value < 0.001). The only exception was the duration of clerkship, which was deemed insufficient both at the beginning and at the end (p value: 0.92). The students perceived that their self-efficacy improved significantly in the majority of basic EM skills and procedures (p value < 0.001). Emergent qualitative themes in the study also supported these results. CONCLUSION: This study showed that a 4-week mandatory EM clerkship increased medical students' perceived self-efficacy in basic emergency management skills. The EM clerkship met students' expectations on knowledge and skill acquisition, and exceeded students' expectations on educational environment.

17.
World J Emerg Surg ; 16(1): 57, 2021 11 19.
Article in English | MEDLINE | ID: mdl-34798873

ABSTRACT

BACKGROUND: The COVID-19 Pandemic lockdowns restricted human and traffic mobility impacting the patterns and severity of road traffic collisions (RTCs). We aimed to study the effects of the COVID-19 Pandemic on incidence, patterns, severity of the injury, and outcomes of hospitalized RTCs trauma patients in Al-Ain City, United Arab Emirates. METHODS: We compared the data of two cohorts of patients which were collected over two periods; the Pandemic period (28 March 2020 to 27 March 2021) and the pre-pandemic period (28 March 2019 to 27 March 2020). All RTCs trauma patients who were hospitalized in the two major trauma centers (Al-Ain and Tawam Hospitals) of Al-Ain City were studied. RESULTS: Overall, the incidence of hospitalized RTC trauma patients significantly reduced by 33.5% during the Pandemic compared with the pre-pandemic period. The mechanism of injury was significantly different between the two periods (p < 0.0001, Fisher's Exact test). MVCs were less during the Pandemic (60.5% compared with 72%), while motorcycle injuries were more (23.3% compared with 11.2%). The mortality of hospitalized RTC patients was significantly higher during the Pandemic (4.4% compared with 2.3%, p = 0.045, Fisher's Exact test). Logistic regression showed that the significant factors that predicted mortality were the low GCS (p < 0.0001), admission to the ICU (p < 0.0001), and the high ISS (p = 0.045). COVID-19 Pandemic had a very strong trend (p = 0.058) for increased mortality. CONCLUSIONS: Our study has shown that the numbers of hospitalized RTC trauma patients reduced by 33.5% during the COVID-19 Pandemic compared with the pre-pandemic period in our setting. This was attributed to the reduced motor vehicle, pedestrian and bicycle injuries while motorcycle injuries increased. Mortality was significantly higher during the Pandemic, which was attributed to increased ISS and reduced GCS.


Subject(s)
COVID-19 , Pandemics , Accidents, Traffic , Communicable Disease Control , Hospital Mortality , Humans , SARS-CoV-2 , United Arab Emirates/epidemiology
18.
PLoS One ; 16(9): e0257398, 2021.
Article in English | MEDLINE | ID: mdl-34529683

ABSTRACT

BACKGROUND: Falls in the Gulf countries are the second most common cause of injuries. The United Arab Emirates government implemented various preventive measures to decrease injuries in the country. We aimed to evaluate the changes in the epidemiology of fall-related injuries in Al-Ain City over the last decade. METHODS: Data of hospitalized patients who presented with fall-related injuries to the Al-Ain Hospital during the two periods of March 2003 to March 2006 and January 2014 to December 2017 were compared. This included patients' demographics, mechanism, location, anatomical distribution and parameters related to injury severity. Non-parametric tests were used for the statistical analysis. RESULTS: 882 in the first and 1358 patients in the second period were studied. The incidence of falls decreased by 30.5% over ten years. The number of elderly, female patients, and UAE nationals increased, (p < 0.001, p = 0.004, and p < 0.001). Falls from height decreased by 32.5% (p < 0.001) while fall on the same level increased by 22.5% (p < 0.001). Fall-related injuries at home have increased significantly by 22.6% (p <0.001), while falls in workplaces decreased by 24.4% (p <0.001). CONCLUSIONS: Our study showed that the overall incidence of falls decreased compared to a decade ago. The preventive measures were effective in reducing falls from height and workplace injuries. Future preventive measures should target falls at the same level and homes.


Subject(s)
Accidental Falls/statistics & numerical data , Wounds and Injuries/epidemiology , Age Factors , Aged , Female , Hospitals , Humans , Male , Middle Aged , Sex Factors , United Arab Emirates/epidemiology
19.
BMJ Case Rep ; 14(6)2021 Jun 09.
Article in English | MEDLINE | ID: mdl-34108158

ABSTRACT

A man in his 30s was brought by ambulance to the emergency department with a complaint of frank bright red rectal bleeding and dizziness. His blood pressure was 60/18 mm Hg. He was resuscitated with intravenous normal saline and an emergency blood transfusion. Following a negative emergency oesophagogastroduodenoscopy and colonoscopy, an angiographic CT of the abdomen revealed a large tumour in the ileum. After failing to stabilise him with multiple blood transfusions, he had an emergent laparotomy and surgical resection of the tumour, which was confirmed by histocytology as gastrointestinal stromal tumour (GIST). He made full recovery and was discharged home after 10 days. We discussed the challenges of managing significant lower gastrointestinal bleeding and reviewed the current management of GIST.


Subject(s)
Abdominal Cavity , Gastrointestinal Stromal Tumors , Angiography , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/surgery , Gastrointestinal Stromal Tumors/complications , Gastrointestinal Stromal Tumors/diagnosis , Gastrointestinal Stromal Tumors/surgery , Humans , Laparotomy , Male
20.
Medicine (Baltimore) ; 100(22): e26258, 2021 Jun 04.
Article in English | MEDLINE | ID: mdl-34087916

ABSTRACT

ABSTRACT: We aimed to study the epidemiological changes in geriatric trauma in Al-Ain City, United Arab Emirates, in the past decade to give recommendations on injury prevention.Trauma patients aged 65 years and above who were hospitalized at Al-Ain Hospital for more than 24 hours or died in the hospital after their arrival regardless of the length of stay were studied. Data were extracted from the Al-Ain Hospital trauma registry. Two periods were compared; March 2003 to March 2006 and January 2014 to December 2017. Studied variables which were compared included demography, mechanism of injury and its location, and clinical outcome.There were 66 patients in the first period and 200 patients in the second period. The estimated annual incidence of hospitalized geriatric trauma patients in Al-Ain City was 8.5 per 1000 geriatric inhabitants in the first period compared with 7.8 per 1000 geriatric inhabitants in the second period. Furthermore, mortality was reduced from 7.6% to 2% (P = 0.04). There was a significant increase in falls on the same level by14.9% (62.1%-77%, P = 0.02, Pearson χ2 test). This was associated with a significant increase of injuries occurring at home (55.4%-78.7% P = 0.0003, Fisher Exact test). There was also a strong trend in the reduction of road traffic collision injuries which was reduced by 10.8% (27.3%-16.5%, P = 0.07, Fisher Exact test).Although the incidence and severity of geriatric trauma did not change over the last decade, in-hospital mortality has significantly decreased over time. There was a significant increase in injuries occurring at homes and in falls on the same level. The home environment should be targeted in injury prevention programs so as to reduce geriatric injuries.


Subject(s)
Accidental Falls/prevention & control , Health Services for the Aged/statistics & numerical data , Wounds and Injuries/epidemiology , Wounds and Injuries/prevention & control , Accidental Falls/mortality , Accidental Falls/statistics & numerical data , Accidents, Traffic/statistics & numerical data , Aged , Aged, 80 and over , Female , Glasgow Coma Scale/standards , Glasgow Coma Scale/statistics & numerical data , Health Services for the Aged/trends , Hospital Mortality/trends , Hospitalization/statistics & numerical data , Humans , Incidence , Injury Severity Score , Male , Prospective Studies , Registries , United Arab Emirates/epidemiology , Wounds and Injuries/mortality
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