Medicine
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The intubation difficulty scale (IDS) includes 7 contributors that provide a comprehensive assessment of difficult intubation. However, the effect of each contributor is unclear, and the scale has not been revalidated recently and has not been validated in orient. This study determined the duration of successful intubation (DSI) for each of these 7 contributors. ⋯ We confirmed that each IDS contributor affects the DSI and validated a prediction model with 6 IDS contributors. This prediction model may facilitate the development of strategic plans for critical airway management. Furthermore, it could improve simulations and monitor learning progress and help provide valuable feedback.
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To investigate the usefulness of the videofluoroscopic swallowing study (VFSS) for subacute stroke in predicting long-term all-cause mortality, including not only simple parameters obtained from VFSS results, but also recommended dietary type as an integrated parameter. This was a retrospective study of patients with subacute (<1 month) stroke at a university hospital between February 2014 and September 2019. The independent risk factors were investigated using stepwise Cox regression analysis, which increased the all-cause mortality of patients with stroke among VFSS parameters. ⋯ The recommended dietary type determined after VFSS in subacute stroke was a significant risk factor for all-cause mortality as an integrated parameter for dysphagia. Among the VFSS parameters, fluid penetration and aspiration were important risk factors for all-cause mortality in patients with moderate dysphagia after stroke. Therefore, it is important to classify the degree of dysphagia by performing the VFSS test in the subacute period of stroke and to determine the appropriate diet and rehabilitation intervention for mortality-related prognosis.
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Diabetes is considered an independent risk factor for hip fracture. In the present study, we evaluated whether perioperative glucose variability (GV) was a significant predictor of the outcomes of patients with diabetes after hip fracture. We analyzed the characteristics and outcomes of all patients with hip fractures admitted to our hospital between September 2008 and December 2012. ⋯ Patients with diabetes had poor prognoses after hip fracture. Perioperative GV is an independent predictor of mortality in patients with diabetes. Therefore, GV might be considered a valid additional parameter to consider in the management of these patients.
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Observational Study
Uncontrolled blood pressure among hypertensive adults with rheumatoid arthritis in Saudi Arabia: A cross-sectional study.
Despite the availability and advancement of diagnostic and treatments with demonstrated benefits in minimizing cardiovascular morbidity and mortality, hypertension control rates remain suboptimal. Therefore, this research aimed to determine the prevalence of uncontrolled BP in rheumatoid arthritis (RA) patients and understand all potential risk factors for uncontrolled BP. We conducted a cross-sectional study on RA patients in 2 rheumatology clinics in 2 public hospitals in Riyadh. ⋯ Among the patients with comorbid conditions, those with obesity, hyperlipidemia, diabetes, anemia, cancer, and reflex or gastroesophageal reflux disease also showed a significantly higher risk of uncontrolled BP (P < .05). The rate of uncontrolled BP was found to be alarmingly high in the study population. Age, gender, smoking, diabetes, obesity, hyperlipidemia, cancer, gastroesophageal reflux disease, and osteoporosis are independently linked with lack of BP control.
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To investigate the predictive value of arterial blood lactate (Lac)/serum albumin (Alb) ratio (Lac/Alb) on myocardial injury in elderly patients with severe community-acquired pneumonia (SCAP). Seventy-two elderly SCAP patients hospitalized in the intensive care unit (ICU) of the emergency department of Hebei General Hospital from March 2020 to March 2021 were included, and the general data and arterial blood Lac and serum Alb levels were collected, and Lac/Alb values were calculated. The patients were divided into myocardial injury group (n = 25) and nonmyocardial injury group (n = 47) according to whether the myocardial injury occurred during their ICU stay, and the predictive value of Lac/Alb on myocardial injury in elderly patients with SCAP was assessed using receiver operating characteristic curve and area under the curve. ⋯ Neutrophils, neutrophil/lymphocyte ratio, serum creatinine, Lac, and Lac/Alb showed a weak positive correlation with myocardial injury in patients (all P < .05). The area under the curve of Lac/Alb for predicting myocardial injury in elderly patients with SCAP was 0.737 (95% confidence interval 0.620-0.834), and the sensitivity and specificity of the prediction with 1.21 as the cutoff value were 60.00% and 78.72%, respectively. Lac/Alb has an excellent predictive value for myocardial injury in elderly SCAP patients.