ABSTRACT
Background "Bounce back" patients is a term used to refer to patients returning to the emergency department within 72 hours after the first visit. This can be attributed to various factors related to diagnosis, management, or the health care system. Objective This study sought to evaluate the extent of bounce-back patients in the emergency department of King Abdullah Medical City (KAMC), Makkah, Saudi Arabia, and then explore the possible relationship between shock index (SI) and bounce-back patients. Methods This is a retrospective chart review of the electronic system among patients who have returned to the emergency department within 72 hours from the index visit. All records were reviewed from May 2019 to May 2021. Vital signs were collected to calculate the shock index (heart rate/systolic blood pressure). The data were analyzed by SPSS Statistics v.27.0 (IBM Corp., Armonk, NY). Results A total of (506) responses were analyzed. The median age was 56 years with an IQR of 40-67, and males represented 55.3%. Around three-quarters of the second complaints (76.9%) were related to the index visit. The durations between the visits were as follows: 51.8% within 24 hours, 30.2% within 25-48 hours, and 18% within 49-72 hours. The median and IQR for shock index were 0.67 and 0.59-0.80 respectively, while the median and IQR for reverse shock index were 1.49 and 1.25-1.71 respectively. Diabetes and the duration between the two visits were associated with the complaints (p-value=0.005, p-value=0.011) respectively. Conclusion The majority of bounce-back cases occurred within the first 24 hours in our sample. Hypertension, diabetes, and ischemic heart diseases were the most prevalent comorbidities among the bounce-back patients. The majority of bounce-back patients (76.9%) presented with complaints related to the index visit.
ABSTRACT
Introduction: Influenza vaccination is the primary control measure for severe complications caused by influenza viruses. Moreover, in the face of the COVID-19 pandemic, Saudi Arabia recommends vaccinating people at risk against influenza to minimise co-infection risk with SARS-CoV2. Therefore, this study aims to assess the Saudi population's knowledge, attitude, and practice toward influenza vaccination during the COVID-19 pandemic. Moreover, we evaluate the impact of the COVID-19 pandemic on seasonal influenza vaccination. Methods: This cross-sectional study was conducted using an online survey in Saudi Arabia between July to August 2021. Participants were invited to complete the questionnaire through a survey link sent to social media platforms. Results: A total of 2410 participants were included in this study. Our data demonstrate a lack of practice, attitude, and knowledge, especially on the influenza virus's symptoms, viral transmission, and vaccine efficacy. Moreover, this study showed that the COVID-19 pandemic significantly impacted seasonal influenza vaccination in the Saudi population by 1.5-times compared to the previous years. Conclusion: COVID-19 pandemic has increased the hesitancy of Saudi participants in influenza vaccination due to the lack of knowledge. As the pandemic of COVID-19 is fading, awareness campaigns are needed to encourage the public about the importance of receiving the influenza vaccine, especially for those at high risk each year.
