RESUMO
BACKGROUND: Community-acquired pneumonia (CAP) is a leading cause of intensive care unit (ICU) morbidity and mortality. Despite extensive international epidemiological and clinical studies to improve those patients' outcomes, local statistics in Saudi Arabia are limited. The objective of this study is to describe the clinical characteristics and outcomes of patients admitted to the ICU with the diagnosis of CAP reflecting the experience of a tertiary center over an 18-year period. METHODS: A retrospective cohort study included all consecutive adult ICU patients diagnosed with CAP between 1999 and 2017. Baseline demographics, patients' risk factors, and initial admission laboratory investigations were compared between survivors and nonsurvivors. A multivariate regression model was used to predict mortality. RESULTS: During the study period, there were 3438 patients admitted to the ICU with CAP (median age 67 [Quartile 1, 3 (Q1, Q3) 51, 76] years) and 54.4% were males, of whom 1007 (29.2%) died. The survivors compared with nonsurvivors were younger (65 vs. 70 years), less likely to have chronic liver disease (2.4% vs. 10.5%), chronic renal failure (8.1% vs. 14.4%), and be immunocompromised (10.2% vs. 18.2%), and less frequently required mechanical ventilation or vasopressors (46.2% vs. 80.5% and 29.6% vs. 55.9%, respectively). Acute Physiology and Chronic Health Evaluation (APACHE) II score was significantly higher among nonsurvivors (median score 26 vs. 20) with a longer duration of mechanical ventilation and ICU stay. Using a multivariate regression model, age, APACHE II score, bilirubin level, vasopressors, and mechanical ventilation were significantly associated with increased mortality, while diabetes was associated with lower mortality. CONCLUSION: Around one-third of patients admitted to the ICU with CAP died. Mortality was significantly associated with age, APACHE II score, vasopressor use, and mechanical ventilation. A comprehensive national registry is needed to enhance epidemiological data and to guide initiatives for improving CAP patients' outcomes.
RESUMO
OBJECTIVES: To investigate asthma prevalence and to measure asthma symptoms among Saudi adults in Riyadh, Kingdom of Saudi Arabia. METHODS: A cross-sectional survey using the European Community Respiratory Health Survey (ECRHS)questionnaire carried out between April and June 2016, among male and female Saudi nationals aged 20-44 years living in Riyadh. Disproportionate cluster sampling method was used. Asthma was defined based on answering "yes" to any of the following: Have you had wheezing when you did not have a cold in the last 12 months? Have you been told by a physician to have asthma? Are you taking medicine for asthma? RESULTS: A total of 2,405 participants completed the survey. The prevalence of wheezing in the last 12 months when not having a cold was 18.2% with no significant difference between males and females (p=0.107). The prevalence of physician-diagnosed asthma was 11.3% with no significant difference between males and females (p=0.239). The prevalence of taking medicine for asthma was 10.6%. There were no significant differences between asthmatic vs. non-asthmatic in terms of residency area (p=0.07), education level (p=0.11) and smoking tobacco (p=0.06). However, significant differences found between asthmatic and non-asthmatic in relation to nasal allergies (p less than 0.001). CONCLUSION: Asthma prevalence is high and much higher than the prevalence reported in most countries using the ECRHS questionnaire.
