National rates of emergency department visits associated with diabetes in Saudi Arabia, 2011-2015

Clinical Characteristics and Risk Factors of Sepsis in Patients with Liver Abscess

Aims/Background Liver abscess (LA) is a serious medical condition that predisposes patients to sepsis. However, predicting sepsis in LA patients has rarely been explored. This study employed univariate and multivariate logistic regression analyses to identify independent risk factors for sepsis, which would provide guidance for clinical diagnosis and treatment. Methods A total of 122 patients with LA treated in Peking University People's Hospital from 1 January 2016 to 31 October 2022 were recruited. Among the cases, 35 patients had sepsis (sepsis group) while the remaining 87 did not have sepsis (non-sepsis group). Clinical data were collected for all enrolled cases. Univariate analysis was performed to identify potential predictors, which were tested in multivariable logistic analysis to pinpoint the independent risk factors for sepsis in LA patients; these findings were utilized to develop a prediction model. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of the prediction model. Informed consent to participate was obtained from the patients or their relatives. Results The incidence of shivering in the sepsis group was significantly higher than that in the non-sepsis group (p < 0.05). Through the univariate analysis, it was found that the reduction in platelet count and prothrombin time activity and the elevation of glycosylated hemoglobin (HbAlc) and procalcitonin (PCT) were more significant in the sepsis group than in the non-sepsis group (p < 0.05). Multivariate logistic regression analysis revealed that PCT and HbAlc were independent risk predictors of sepsis in LA patients within the derivation cohort (p < 0.05). Conclusion Elevated levels of HbAlc and PCT were independent risk factors for sepsis associated with LA. Patients with LA exhibiting elevated PCT levels demonstrated a 21% increased susceptibility to sepsis, and those with elevated HbAlc levels showed a 38% heightened risk for sepsis.

The prevalence and predictors of diabetes in a private health insurance scheme: An analysis of three million beneficiaries in Saudi Arabia

BACKGROUND

Noncommunicable diseases (NCDs) are a leading threat to population health in Saudi Arabia. Addressing NCDs is a priority for health-care transformation, and understanding the current disease prevalence is crucial. The prevalence in other settings is unknown because studies have relied on data from households or public health-care institutions. This study aims to investigate the prevalence and predictors of diabetes in the privately insured population.

MATERIALS AND METHODS

This retrospective study explored the prevalence and predictors of diabetes in beneficiaries aged 15 years or older who sought medical care in 2022. Data were sourced from the National Platform for Health and Insurance Exchange Services, a unified health insurance claim platform. We used the International Classification of Disease-10 to capture the condition. To identify predictors of diabetes, we employed a backward selection approach for logistic regression.

RESULTS

Over 3.3 million beneficiaries sought medical care during the study. The population was relatively young aged 26-39 years, (47.5%) and two-thirds of males. The prevalence of diabetes was 11.0% and varied across regions, with the highest in Bahah (18.4%) and the lowest in Jizan (9.5%). Age, gender, nationality, insurance company size, body mass index, region, hypertension, and coronary heart disease were significant predictors of diabetes. Hypertensive patients were over five times more likely to have diabetes than those without hypertension (odds ratio OR = 5.08; 95% confidence interval CI = 5.02-5.24). Saudis were 30% more likely to have diabetes than other nationalities (OR = 1.3; 95% CI = 1.28-1.31).

CONCLUSION

We found a higher prevalence of diabetes in privately insured beneficiaries than the recent national estimate. This necessitates population health management strategies at all levels (primary, secondary, and tertiary) to mitigate the burden of diabetes in privately insured individuals. This study provides valuable baseline data for the prevalence of diabetes in this population and emphasizes the urgent need for targeted interventions, especially in regions with a higher prevalence.

Xerostomia, Salivary Flow, and Oral Health Status Among Saudi Diabetic Patients: A Comparative Cross-Sectional Study

Purpose

Diabetes mellitus (DM) is associated with numerous oral complications, including frequent oral infections, periodontal diseases, hyposalivation, and xerostomia. The present study aimed to investigate salivary flow rate, xerostomia, and oral health status among a group of Saudi diabetic patients as compared to healthy controls.

Patients and Methods

This comparative cross-sectional study involved 50 diabetic patients (aged between 15 and 70 years) and 53 age- and gender-matched healthy controls. Data collection was carried out using a structured questionnaire and clinical examination of oral health status, which included salivary flow rates, saliva pH, tooth loss, plaque accumulation, and gingival health. Independent t-tests, one-way analysis of variance (ANOVA), and chi-square tests were performed to compare between groups.

Results

The results revealed a statistically significant lower salivary flow (0.33 ± 0.16 vs 0.59 ± 0.54; p = 0.002) and lower saliva pH (6.36 ± 0.49 vs 6.58 ± 0.39; p = 0.014) in diabetic patients than in the control group. A higher proportion of diabetic subjects (60%) self-reported having xerostomia compared to controls (52%), but the findings were statistically non-significant. Additionally, the results revealed slightly poorer oral health and greater tooth loss among DM patients, although the results did not attain a significant difference (P > 0.05).

Conclusion

The findings of the present study demonstrate poor oral health and a high prevalence of xerostomia among Saudi diabetic patients. Oral health education should therefore be promoted in this group of patients.

Epidemiology of Frequent Visits to the Emergency Department at a Tertiary Care Hospital in Saudi Arabia: Rate, Visitors' Characteristics, and Associated Factors

Background

Emergency department overcrowding is becoming a challenge for the healthcare management system globally and locally. This study aimed to estimate the frequency of ED visits, describe the patients’ profile along with visit-related characteristics, and associated factors in a tertiary care hospital.

Methods

A retrospective cohort study was conducted at a tertiary care hospital. The study included patients age 14 years and above visiting the main emergency department in year 2013. Data were extracted from electronic medical records by a qualified data extraction team. Statistical analyses were performed, including the odds ratio and 95% confidence interval for the factors associated with highly frequent (≥14 visits) ED visits using logistic regression models.

Results

There were 150,727 visits to the emergency department within a year. The number of frequent visitors was 7696 (9.38%), with 42,226 visits (28.01% of total ED visits). Highly frequent visitors totaled 249 (0.30%), with 5173 visits (3.43% of total ED visits). The frequent visitors’ average age was 42.55 (SD 20.14), and 48.99 (SD 21.33) for the highly frequent visitors’ group. More than half of the emergency visitors were females. The most common complaints among the highly frequent visitors were Gastrointestinal (21.34%), followed by Respiratory (13.47%), Orthopedic (12.57%), and Cardiovascular (12.43%). Multivariate analysis indicated that age, history of diabetes, history of cardiac diseases, insurance status, and nationality were significant predicators of highly frequent visits to the hospital emergency.

Conclusion

Frequent and highly frequent visitors to emergency departments represent a significant proportion of adult patients presenting to ED. Their visits constitute almost one-third of total ED visits. Several factors associated with highly frequent ED visits have been identified. This study provides local empirical evidence to develop improvement policy and actions related to chronic issue of frequent and highly frequent visitation to hospital ED.