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Background: The ulnar and radial arteries are the major source of blood supply in the hand, as they form the superficial and deep palmar arches. Arterial hand circulation is one of the most complicated arterial trees and connections in the body, with tremendous variations in its structure. This study aimed to evaluate whether the ulnar artery or radial artery is the dominant artery in hand circulation among plastic surgery patients at King Khalid University Hospital and to correlate the arterial hand dominance with handedness and gender. Methods: This is an analytical cross-sectional study conducted at King Khalid University Hospital in Riyadh, Saudi Arabia, on plastic surgery patients. The sampling method is purposive sampling. The calculated sample size is 28; however, 100 participants have been enlisted in the study. The data have been collected using the modified Allen test with a pulse oximeter. Results: The collective prevalence of dual arterial dominance in our study was 69% compared with 56% and 30% for Little et al (P = 0.013) and Fuhrman et al (P < 0.001), respectively. With regard to gender, women were more likely to have a dual arterial blood supply than men, with the frequency values of 85% and 58.3% for women and men, respectively (P = 0.017). Conclusions: Our study found that dual arterial supply is predominant among our participants, with 69% of our participants possessing a dual arterial supply, while 18% and 13% constitute the prevalence of radial and ulnar dominance, respectively. This contrasts with what has been reported previously in the literature.
RESUMO
BACKGROUND: Cancer patients are highly prone to develop bacterial bloodstream infections (BSI) and are also at risk of neutropenia. Knowledge of the prevalence of these infections and whether neutropenia is associated with a change in mortality is important to more effective management and reducing mortality and morbidity. OBJECTIVES: Estimate the prevalence of bacterial BSI among oncology inpatients and assess the associations of 30-day mortality with Gram stain results and neutropenia. DESIGN: Retrospective cross-sectional SETTING: University hospital in Saudi Arabia. PATIENTS AND METHODS: We retrieved records of oncology inpatients at King Khalid University Hospital, excluding patients without malignancy and with non-bacterial BSI. The number of records included in the analysis was reduced based on a sample size calculation and systematic random sampling used to select patients to include in the study. MAIN OUTCOME MEASURES: Prevalence of bacterial BSI and association between neutropenia and 30-day mortality. SAMPLE SIZE: 423. RESULTS: The prevalence of bacterial bloodstream infections was 18.9% (n=80). Gram-negative bacteria were more prevalent (n=48, 60.0%) than gram-positive bacteria, with the most common being Escherichia coli (n=20, 25.0%). The 23 patients (28.8%) who died included 16 (69.6%) with gram-negative infections and 7 (30.4%) with gram-positive infections. There was no statistically significant association of bacterial BSI-related 30-day mortality with Gram stain (P=.32). Of 18 patients (22.5%) who were neutropenic, only one (5.6%) died. Sixty-two (77.5%) patients were non-neutropenic, of whom 22 (35.50%) died. We found a statistically significant association between the presence of neutropenia and bacterial BSI-related 30-day mortality (P=.016), with mortality being lower among neutropenic patients. CONCLUSIONS: Gram-negative bacteria are more prevalent in bacterial BSI than gram-positive bacteria. No statistically significant association of Gram stain result with mortality was found. However, the 30-day mortality rate was lower among neutropenic patients than among non-neutropenic patients. We recommend further investigation with a larger sample size in multiple regions to further unravel the association of neutropenia with bacterial bloodstream infection-related 30-day mortality. LIMITATIONS: Lack of regional data and sample size. CONFLICT OF INTEREST: None.
