Chronic diseases such as diabetes and vascular disease are a major public health problem in Lebanon, where primary care is not well developed. This study aimed to describe the incidence and indications for limb amputation in Lebanon and identify associated factors (age, sex, level of surgery, length of hospital stay). There were 1.6 amputations per 10 000 persons. The rate of amputation was highest in southern Lebanon at 3.8 per 10 000. The most important indication for surgery was diabetes (59%). Diabetic patients were older (mean age 73 years versus 30 years), more likely to have major surgery (OR = 7.87; 95% CI: 2.83-21.9) and stay in hospital longer (RR = 4.56, 95% CI: 2.41-8.64) than patients with trauma-related amputation. Diabetes prevention, detection and management should be prioritized in any attempt to reduce the current incidence of amputation in Lebanon. RÉSUMÉ Des maladies chroniques telles que le diabète et les maladies vasculaires sont un problème de santé publique majeur au Liban, où les soins de santé primaires ne sont pas bien développés. L'étude visait à décrire l'incidence et les indications des amputations au Liban et à déterminer les facteurs associés (âge, sexe, niveau de chirurgie, durée de l'hospitalisation). L'étude a comptabilisé 1,6 amputation pour 10 000 personnes. Le sud du Liban présentait le taux d'amputation le plus élevé avec 3,8 amputations pour 10 000. Le diabète était l'indication la plus importante pour une chirurgie (59 %). Les patients diabétiques étaient plus âgés (âge moyen 73 ans par rapport à 30 ans), étaient plus susceptibles de subir une intervention chirurgicale importante (OR = 7,87 ; IC à 95 % : 2,83-21,9) et de séjourner plus longtemps à l'hôpital (RR = 4,56 ; IC à 95 % : 2,41-8,64) que les patients ayant eu une amputation suite à un traumatisme. La prévention du diabète, son dépistage et sa prise en charge doivent devenir prioritaires afin de tenter de réduire l'incidence actuelle des amputations au Liban.
Introduction. The verbal, eye, and motor components of Glasgow coma scale (GCS) may be influenced by poisoned patients' behavior in an attempted suicide. So, the values of admission GCS and its components for outcomes prediction in mixed drugs poisoning were investigated. Materials and Methods. A followup study data was performed on patients with mixed drugs poisoning. Outcomes were recorded as without complications and with complications. Discrimination was evaluated by calculating the area under the receiver operating characteristic curves (AUC). Results. There was a significant difference between the mean value of each component of GCS as well as the total GCS between patients with and without complication. Discrimination was best for GCS (AUC: 0.933 ± 0.020) and verbal (0.932 ± 0.021), followed by motor (0.911 ± 0.025), then eye (0.89 ± 0.028). Conclusions. Admission GCS and its components seem to be valuable in outcome prediction of patients with mixed drug poisoning.
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