No abstract

Small area analyses of CCF have identified significant gaps in the management of CCF in the community. This may be a reflection of deficit in primary care availability, accessibility, or appropriateness. Detailed studies may be needed to determine the relative importance of these factors in Victoria for targeting specific interventions at the PCP level.

Background: Hypertensive emergency (HTNE) diagnostic code was introduced, in the US, in October 2016 to improve identification of patients with end-organ damage due to high blood pressure but its impact is unclear. Objective: To assess the accuracy of HTNE code using administrative data. Methods: We used National Inpatient Sample 2017 to identify adult patients, age ≥18 years, with International Classification of Disease-10th Clinical modification (ICD-10-CM) code of I16.1. We used the presence of end-organ damage diagnostic codes to identify true HTNE. Results: A total of 194,495 patients had a diagnosis of HTNE. Of these only 144,070 (74.1%) had a concomitant diagnosis of end-organ damage. Baseline characteristics of entire cohort stratified by presence of target organ damage (Table 1A) and frequency of end-organ damage in true HTNE patients (Table 1B) are shown. Patients with true HTNE were likely to be older and male with higher co-morbidity burden. There was also significant difference in outcomes between two groups with a higher proportion of true HTNE patients experiencing longer length of stay and increased mortality which is in-line with previous studies. Conclusions: The accuracy of hypertensive emergency diagnosis code is low with positive predictive value of 74.1% and caution is advised when using with administrative data. Further studies, using individual patient discharge records, are required to validate HTNE code.

Objective: To present primary causes of in-hospital mortality in large surgical population who underwent surgical correction for CHDs for the period of a decade at our institute. Methods: Retrospective analysis of pediatric cardiac surgery database along with decision of morbidity and mor-tality meeting at Department of Cardiac Surgery at CPE Institute of Cardiology from January 2009 to April 2021. Results: An overall 3705 patient underwent surgery for CHDs. The in-hospital mortality for CHDs surgery is 2.37% with RV dysfunction, Residual cardiac defect with valve dysfunction (TR/PR), pulmonary hypertensive complication, mediastinal bleeding, cardiac tamponade, respiratory complication, MODs, heart block as major primary cause of in-hospital mortality with frequency of 15.91%, 18.18%, 18.18%,18.18%,9.09%,10.23%, 4.54% and 4.54% respectively. Conclusion: in our population of 3705 congenital cardiac surgery patients, incidence of overall in-hospital mortali-ty is promising for wide range of CHDs. RV dysfunction, residual RV defects with vale regurgitation, pulmonary hypertension, bleeding complications and respiratory failure are major primary causes of in-hospital mortality. Keywords: In-hospital Mortality, Atrial septal defect (ASD), Tetralogy of Fallot (TOF), Ventricular septal defect

Objective To evaluate the pattern of injuries and available prehospital and hospital care in this rapidly emerging country with western type hospital and trauma care resources serving a population that in many areas is still considered to be developing. Setting Accident & Emergency Department of King Khalid National Guard Hospital, Jeddah, Saudi Arabia. Method Records of all patients admitted to the accident and emergency department sustaining injuries due to trauma were studied, including patients brought in dead. Results Injuries represented 10% of all accident and emergency referrals. Falls were the most common cause of injury, followed by sports injuries and road traffic accidents. The male to female ratio for all injuries was 3:1; 84% of injured patients were below the age of 30 years with 34% 10 years old or less. Sprains and strains were the commonest injury type (23%); followed by lacerations (20%) and fractures (19%). Total mortality among seriously injured patients was 35%. Eight out of 14 brought in dead to the accident and emergency department had an ISS of less than 30 and four had a score of less than 18. Conclusions Trauma constitutes a major cause of mortality in Saudi Arabia. Road traffic accidents account for only 10% of injured patients, but cause greatest mortality and morbidity. Untrained ambulance staff and the lack of paramedics were identified as causal in the mortality among patients brought dead to the accident and emergency department with a very low injury severity score. Recommendations are made to improve the outcome of trauma victims.