IntroductionHigh white blood cell (WBC) count is an indicator of sickle cell disease (SCD) severity, however, there are limited studies on WBC counts in Saudi Arabian patients with SCD. The aim of this study was to estimate the prevalence of abnormal leukocyte count (either low or high) and identify factors associated with high WBC counts in a sample of Saudi patients with SCD.MethodsA cross-sectional and retrospective chart review study was carried out on 290 SCD patients who were routinely treated at King Fahad Hospital in Hofuf, Saudi Arabia. An interview was conducted to assess clinical presentations, and we reviewed patient charts to collect data on blood test parameters for the previous 6 months.ResultsAlmost half (131 [45.2%]) of the sample had abnormal leukocyte counts: low WBC counts 15 (5.2%) and high 116 (40%). High WBC counts were associated with shortness of breath (P=0.022), tiredness (P=0.039), swelling in hands/feet (P=0.020), and back pain (P=0.007). The mean hemoglobin was higher in patients with normal WBC counts (P=0.024), while the mean hemoglobin S was high in patients with high WBC counts (P=0.003). After adjustment for potential confounders, predictors of high WBC counts were male gender (adjusted odds ratio [aOR]=3.63) and patients with cough (aOR=2.18), low hemoglobin (aOR=0.76), and low heart rate (aOR=0.97).ConclusionAbnormal leukocyte count was common: approximately five in ten Saudi SCD patients assessed in this sample. Male gender, cough, low hemoglobin, and low heart rate were associated with high WBC count. Strategies targeting high WBC count could prevent disease complication and thus could be beneficial for SCD patients.
BackgroundAlthough the frequency of surgical weight loss interventions has increased in Saudi Arabia, literature describing the clinical outcomes of bariatric surgery in Saudi Arabia is limited. This study aimed to assess whether weight loss intervention improves hemoglobin A1c (HbA1c) in obese patients and to identify its associated factors.Patients and methodsA retrospective study was carried out on 318 patients with obesity class 1 or higher (body mass index [BMI] ≥ 30 kg/m2) who underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass at King Abdulaziz Medical City in Riyadh, Saudi Arabia, between January 1, 2001 and March 31, 2017. Preoperatively and 12 months postoperatively, characteristics of patients were collected. BMI reduction was calculated, based on which patients were divided into three groups (0–9, 10–14, and >14 kg/m2).ResultsThe postoperative HbA1c was 5.83±0.9, while the baseline level was 6.74±2.1 (P=0.001). Fifty-eight of the 318 patients had diabetes. We observed significantly higher HbA1c in diabetic than in non-diabetic patients preoperatively, whereas an insignificantly different HbA1c was observed postoperatively. Among those who had minimal reduction in BMI (0–9 kg/m2), we observed significantly higher HbA1c in diabetic than in non-diabetic patients, whereas among those who had large reduction in BMI (10–14 kg/m2) and (>14 kg/m2), we observed insignificant differences in HbA1c in diabetic than in non-diabetic patients.ConclusionBeing a diabetic patient was related to a significant reduction in HbA1c levels postoperatively. The study suggests that the reduction in HbA1c levels could be modified by BMI, wherein greater reduction in BMI leads to greater reduction in HbA1c levels.
Background: The impact of age on complications following bariatric surgery remains unclear. Research is therefore warranted among previously unstudied populations of bariatric surgery patients. The aim of the current study was to assess the impact of age on postoperative complications following bariatric surgery in Saudi Arabia. Methods: This retrospective study included 301 patients who underwent bariatric surgery between January 2011 and July 2016. Patients were classified into three groups according to age: < 25 years; 25–36 years; and >36 years. Primary outcomes were determined by identifying the number of complications reported during a period of 180 days. The negative binomial model was used to assess the relationship between age and the high rate of postoperative complications following adjustment for confounding variables. Results: The incidence of overall complications was 10.1% in the < 25-year age group, 15% in the 25–36-year age group, and 24.2% in the >36-year age group. After adjusting for confounding variables, it was discovered that the risk of postoperative complications increases with age. The risk was higher in the >36-year age group than in the >25-year age group [adjusted relative rate (aRR) = 2.35; 95% confidence interval (CI) = 1.046–5.290; p = 0.039]. Diabetes (aRR = 3.27), adjustable gastric bands (aRR = 3.40), and a more lengthy hospital stay (aRR = 1.23) were associated with increased rates of postoperative complications. Conclusion: Age is independently associated with a high rate of postoperative complications following bariatric surgery. The results showed that patients with diabetes, those using adjustable gastric bands, and those with longer length of hospital stay had significantly higher incidence of postoperative complications. These findings indicate the need for risk stratification tools to evaluate patients as candidates for bariatric surgery and to use as a guide for identifying optimal preoperative factors.
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