RESUMEN

Objectives: The present study analyzed in-hospital first-time stroke mortality in southwestern Saudi Arabia over one-year to assess the in-hospital stroke case fatality rate, mortality rate and explore the factors associated with in-hospital stroke mortality. Study Design: Hospital based follow-up study. Methods: First-time stroke patients admitted to all hospitals in Asser region over one-year period (January through December 2016) were included in the study. Data about personal characteristics, pre-stroke history and clinical criteria, on admission clinical criteria, in-hospital complications and survival status were collected. The last reported Aseer region population was used to calculate age and sex stroke mortality rate per 100,000 population/year. Hazard ratios (HR) and concomitant 95% confidence intervals (95% CI) were computed using multivariate Cox regression survival analysis. Kaplan-Meier curve survival analysis for stroke patients were plotted. Results: A total of 121 in-hospital deaths out of 1249 first-time stroke patients giving an overall case fatality rate (CFR) of 9.7%. Non-significant difference with gender and age were observed in CFR. Overall, in-hospital stroke mortality rate was 5.58 per 100,000/year. Males and elders showed a significantly higher mortality rates. Multivariable Cox regression analyses revealed pre-stroke smoking (HR = 2.36), pre-stroke hypertension (HR = 1.77), post-stroke disturbed consciousness (HR = 6.86), poor mobility (HR = 2.60) and developing pulmonary embolism (HR = 2.63) as significant predictors of in-hospital stroke mortality. Conclusions: In Southwestern Saudi Arabia, the in-hospital stroke mortality rate is higher in men and increases with aging. The prognosis of acute stroke could be improved by smoking cessation, better control of hypertension and prevention of in hospital complication particularly pulmonary embolism.

Asunto(s)

Mortalidad Hospitalaria , Accidente Cerebrovascular/mortalidad , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/epidemiología , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Limitación de la Movilidad , Análisis Multivariante , Pronóstico , Modelos de Riesgos Proporcionales , Embolia Pulmonar/epidemiología , Análisis de Regresión , Factores de Riesgo , Arabia Saudita/epidemiología , Factores Sexuales , Fumar/epidemiología , Accidente Cerebrovascular/epidemiología

RESUMEN

Recent data regarding first-stroke incidence in Saudi Arabia in general and in the Aseer region in particular are scarce and even lacking. The aim of this work was to study the first-time stroke incidence in the Aseer region, southwestern Saudi Arabia. All first-stroke patients admitted to all hospitals in the Aseer region over a one-year period (January through December 2016) were included. Stroke patients outside the Aseer region were excluded from the study. The incidence per 100,000 patients and the concomitant 95% CI (Confidence Intervals) were computed. The present study included 1249 first-time stroke patients and calculated an overall minimal incidence rate of hospitalized first-time stroke of 57.64 per 100,000 persons per year (95% CI: 57.57-57.70). A steady increase was noticed depending on the patients' age, reaching a figure of 851.81 (95% CI: 849.2-854.5) for those patients aged 70 years and more. Overall, the incidence rate for females (48.14; 95% CI: 48.04-48.24) was lower compared to males (65.52; 95% CI: 65.1-66.0). Taking into consideration the expected rise of the elderly because of the prominent medical services provided by the Saudi government, leading to a subsequent change in the horizontal and vertical age distribution structure of the population, an increase in the number of stroke patients is expected. It is suggested to establish a nationwide stroke surveillance system in the Kingdom, with the objective to report, analyze, and maintain an updated overview of the stroke status in Saudi Arabia.

Asunto(s)

Accidente Cerebrovascular/epidemiología , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Arabia Saudita/epidemiología , Distribución por Sexo

RESUMEN

PURPOSE: The aim of this is to find out the hand hygiene (HH) knowledge among primary health care workers (PHCWs) in Abha health district, southwestern Saudi Arabia. METHODS: Data were collected through an anonymous self-administered questionnaire. The questionnaire was based on a WHO "Knowledge Questionnaire for Health Care Workers." RESULTS: The study included 478 PHCWs (239 males and 239 females). The sample included 186 physicians, 212 nurses, and 80 technicians. The highest proportion receiving formal training was nurses (82.1%). Females (77.4%) received significantly more training than males (70.3%). Only 59.2% (283) of the HCWs properly identified unclean hands of HCWs as the main route of the cross. Only 26.4% (126) of the HCWs properly identified germs already present on or within the patient as the most frequent source of pathogens in a health-care facility. Only 54.8% (262) of HCWs properly identified 20 s as the minimal time needed for alcohol-based hand rub to kill most germs on hands. CONCLUSION: The study revealed gaps in the knowledge regarding HH. To promote HH at primary health care setting, WHO bundle of multimodal strategies should be adopted including system change; training/education; evaluation and feedback; reminders in the workplace; and institutional safety climate.