ABSTRACT
Rationale. By reducing cerebral oxygen delivery, anemia may aggravate traumatic brain injury (TBI) secondary insult. This study evaluated the impact of anemia and blood transfusion on TBI outcomes. Methods. This was a retrospective cohort study of adult patients with isolated TBI at a tertiary-care intensive care unit from 1/1/2000 to 31/12/2011. Daily hemoglobin level and packed red blood cell (PRBC) transfusion were recorded. Patients with hemoglobin < 10 g/dL during ICU stay (anemic group) were compared with other patients. Results. Anemia was present on admission in two (2%) patients and developed in 48% during the first week with hemoglobin < 7 g/dL occurring in 3.0%. Anemic patients had higher admission Injury Severity Score and underwent more craniotomy (50% versus 13%, p < 0.001). Forty percent of them received PRBC transfusion (2.8 ± 1.5 units per patient, median pretransfusion hemoglobin = 8.8 g/dL). Higher hospital mortality was associated with anemia (25% versus 6% for nonanemic patients, p = 0.01) and PRBC transfusion (38% versus 9% for nontransfused patients, p = 0.003). On multivariate analysis, only PRBC transfusion independently predicted hospital mortality (odds ratio: 6.8; 95% confidence interval: 1.1-42.3). Conclusions. Anemia occurred frequently after isolated TBI, but only PRBC transfusion independently predicted mortality.
ABSTRACT
OBJECTIVE: To assess Saudi patients' preferences regarding Saudi physicians' attire, and its influence on patients' level of trust and confidence in their physician. METHODS: A cross-sectional survey was conducted from May to June 2011 among patients waiting to be seen by their physicians from the outpatient medical clinics of King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Patients were asked multiple questions, which included their choice of preference regarding the attire of male and female physicians. Additionally, patients were asked questions related to their preferences regarding their physician's gender, and the influence of physician's appearance on patient confidence. RESULTS: A total of 399 patients were interviewed (231 males, 168 females). The mean age was 37 years. Most of the patients (62%) preferred physicians` formal outfit, which was is defined as; tie, shirt, and trousers. Only 9.7% of the patients preferred national Saudi attire (thoab and shemagh). Most patients (73%) preferred long skirts to be worn by female doctors. Up to 85% of patients preferred the white coat to be worn by physicians. Approximately 50% of the patients expressed no preference regarding the gender of their physicians. Confidence in the physician's competence and experience was not significantly associated with the physician's attire or gender (p=0.238). CONCLUSION: Most patients prefer physicians to wear formal attire, however, the gender of the treating physician was not shown to be of particular importance. In addition, the level of trust in a physician is not related to his/her external appearance.