RESUMO
INTRODUCTION: The total number of ICU admissions for COVID-19 patients has increased steadily. Based on the research team's clinical observations, many patients developed rhabdomyolysis, but few cases were reported in the literature. This study explores the incidence of rhabdomyolysis and its outcomes, like mortality, the need for intubation, acute kidney injury, and the need for renal replacement therapy (RRT). METHODS: We retrospectively reviewed the characteristics and outcomes of patients admitted to the ICU at a COVID-19-designated hospital in Qatar between March and July 2020. Logistic regression analysis was used to determine factors associated with mortality. RESULTS: 1079 patients with COVID-19 were admitted to the ICU, and 146 developed rhabdomyolysis. Overall, 30.1% died (n = 44), and 40.4% developed Acute Kidney Injury (AKI) (n = 59), with only 19 cases (13%) recovering from the AKI. AKI was significantly associated with increased mortality rates among rhabdomyolysis patients. Moreover, significant differences were found between groups regarding the subject's age, calcium level, phosphorus level, and urine output. However, the AKI was the best predictor of mortality for those who got the COVID-19 infection and rhabdomyolysis. CONCLUSION: Rhabdomyolysis increases the risk of death in COVID-19 patients admitted to the ICU. The strongest predictor of a fatal outcome was acute kidney injury. The findings of this study emphasize the importance of early identification and prompt treatment of rhabdomyolysis in patients with severe COVID-19.
RESUMO
Background The balanced scorecard (BSC) system provides the basis for developing and executing a good strategy and successfully managing change at the institutional level. Moreover, developing a BSC performance system at the Medical Commission Department (MCD) in Qatar will enable stakeholders to approach their organization and work in a more strategic manner. Methods A descriptive cross-sectional survey was conducted to determine the need of employees at the MCD for the BSC, as a performance management tool, to attain the organizational objectives. Thus, a simple random sample was employed to enroll 199 participants. Also, a self-administered validated English and Arabic survey tool was employed to collect socio-demographic characteristics and encompassed 20 questions on the needs assessment for BSC. Results The response rate was high (97.5%) while the scoring indicates difficulty in successfully executing the MCD strategy and meeting the needs of their customers. The results showed a medium score of need to implement the BSC (score =59.9±9.7). The BSC needs score was strongly associated with the item "Our employees have a solid understanding of the mission, vision, and strategy" and it was higher among nationals as well as those with a higher level of education. Conclusion The BSC system provides the basis for properly executing a strategy and successfully managing change in an organization. Thus, building a BSC performance system at the MCD will enable employees to think in a more strategic way about their organization and their work. It will also bring change in the way things are done, as new policies and procedures will be developed and be implemented accordingly.
