Poisoning-related emergency department visits: the experience of a Saudi high-volume toxicology center.

BACKGROUND: Acute poisoning is a major contributing factor to mortality and morbidity. There is a lack of research on the epidemiology of acute poisoning risk factors in Saudi Arabia. OBJECTIVES: Descriptive overview of poisoning cases at a tertiary care center. DESIGN: Descriptive, medical record review. SETTINGS: Tertiary care center in Riyadh. PATIENTS AND METHODS: From the electronic medical record system, we collected demographic information, medical history, and the poisoning history on all emergency department visits diagnosed as acute poisoning from January 2016 to January 2021. Patients were classed as children (<18 years old) or adults, and further classified by body mass index. MAIN OUTCOME MEASURES: Intensive care unit (ICU) admission, organ transplantation, and mortality were classified as poor outcomes. SAMPLE SIZE: 492 adults and 1013 children (<18 years old) were identified. RESULTS: The most frequent agent in poisoning for both groups was acetaminophen (n=52, 10.57% and n=100, 9.87%, respectively). The ICU admission rate was 6.7% and 4.8%, and the mortality rate 0.8% and 0.3%, respectively. The accidental poisoning rate was 57.7% among adults (n=284) and 67.6% among children (n=658). The suicide intention rate was 11.2% (n=55) and 7.4% (n=75) among adults and children, respectively. The management for both populations was nonspecific, involving observation, supportive measures, and symptomatic treatment. CONCLUSION: Although the ICU admission rates were consistent with reported data, the mortality rate was marginally lower. The pediatric predominance in the population implies a lack of caregiver education in the region regarding the safe storage of drugs and household products, as well as the use of child-resistant packaging. The high rate of accidental poisoning in both age groups should prompt further investment to promote public health education on the rational use and safe storage of toxic agents and self-protection. The high suicide intention rate needs to be investigated to develop multidisciplinary risk prevention strategies. LIMITATIONS: Single center, retrospective, small population size. CONFLICT OF INTEREST: None.

Bladder cancer in Saudi Arabia: a registry-based nationwide descriptive epidemiological and survival analysis.

BACKGROUND: Our understanding of the risk factors, prevalence, incidence rate, and age distribution of bladder cancer (BC) in Saudi Arabia is insufficient due to limited data. OBJECTIVE: Describe the epidemiology and analyze factors associated with survival in patients with BC in Saudi Arabia. DESIGN: Retrospective medical record review. SETTINGS: Registry-based nationwide study. PATIENTS AND METHODS: The study included all records in the Saudi Cancer Registry of patients diagnosed with a primary BC from 1 January 2008 to 31 December 2017. Collected data included year of diagnosis, gender, age, marital status, region and nationality, tumor site of origin, tumor histological subtype, tumor behavior, tumor grade, tumor extent, tumor laterality, the basis of the diagnosis, and survival status. Factors predicting survival were tested by a Kaplan-Meier and Cox proportional hazards regression analysis. MAIN OUTCOME MEASURES: Mortality status on last contact. SAMPLE SIZE: 3750 patients. RESULTS: The overall incidence of BC was 1.4 per 100 000 persons. Significant differences in the distribution of survival were observed by age, gender, nationality, place of residency, tumor morphology, tumor grade and extension. The adjusted predictors of decreased survival were age, squamous cell carcinoma, Grade III and IV bladder tumors, regional direct extension, regional lymph node extension, combined regional lymph node and direct extension, and distant metastasis. Male gender and being widowed were predictors of improved survival in the unadjusted analysis. CONCLUSION: This study provides further understanding of BC in a region with a high prevalence of risk factorsuch as smoking. Highlighting these factors, specifically in Saudi Arabia, improves evidence-based practice in this region and may facilitate appropriate care to optimize outcomes. LIMITATIONS: Retrospective study and underreporting. CONFLICT OF INTEREST: None.