Exogenous low dose melatonin administered nightly to elderly patients admitted to acute care may represent a potential protective agent against delirium.

BackgroundThe use of potentially inappropriate medications (PIMs) is an important issue in older patients who are at risk of adverse drug events.AimTo determine the prevalence of PIM use, according to Beers criteria, among an older population (aged ≥65 years) in a large family medicine setting, and to identify the associated risks.Design & settingA prospective cross-sectional study of patients aged ≥65 years was conducted from June 2017 to June 2018 at the Family and Community Medicine (FCM) clinics of King Saud Medical City (KSMC) in Riyadh, Saudi Arabia.MethodThis cross-sectional study included patients aged ≥65 years who were seen at new appointments or followed-up at the FCM clinics of KSMC in Riyadh, Saudi Arabia. Data were collected by extensive face-to-face interviews and from the patients’ medical records.ResultsA total of 270 older patients aged 72.41 ±6.23 years (mean ±standard deviation [SD]) were included in the present study. The prevalence of PIMs was 60.7% (n = 164). Multivariate analyses identified three independent variables associated with PIMs: incremental age per 5 years (odds ratio [OR] 1.47, 95% confidence intervals [CI] = 1.15 to 1.88; P = 0.002), female sex (OR 1.95, 95% CI = 1.10 to 3.42; P = 0.021), and polypharmacy (OR 8.21, 95% CI = 4.58 to 14.7; P<0.001). The most common PIMs used were 39.4% related to proton pump inhibitors (PPI), 25.2% to diuretics (other than spironolactone), 10.6% to non-steroidal anti-inflammatory drugs (NSAIDs), and 8.7% to aspirin use.ConclusionThis study showed high prevalence of PIMs. Increasing age, female sex, and polypharmacy were found to be significant risk factors for PIM use. The frequency of morbidities was not significantly different among patients with PIMs compared to those without PIMs, except for hypertension and osteoarthritis, which were more common in the PIMs group. The present study reinforces the importance of comprehensive medication management and reviews.

Objectives To assess the hospital beds and intensive care unit (ICU) beds with a ventilator surge capacity of the health system in Kingdom of Saudi Arabia (KSA) during COVID-19 pandemic. Methods This study used relevant data from the National Health Emergency Operation Center to estimate general hospital and ICU beds surge capacity and tipping points under three distinct transmission scenarios. Results The study results reveal that hospitals in the KSA need to be supplied with additional 4,372 hospital beds to care for COVID-19 positive cases if the pandemic continues over six months period. At the same time, it requires additional 2,192 or 1,461 hospital beds if the pandemic persists over a 12- or 18-months period, respectively, to manage hospitalized COVID-19 overloads. The health system surge capacity would suffer from a shortage of 1,600, 797, and 540 ICU beds under the three transmission scenarios to absorb critical and intensive care COVID-19 cases. Conclusion Our findings highlight the urgent need for additional hospital and ICU beds in the face of critical COVID-19 cases in KSA. The study recommends further assessment measures to the health system surge capacity to keep the Saudi health system prepared during the COVID-19 pandemic.

Background The aim of this study was to identify the predictors of hospitalization in older (≥60 years) patients with coronavirus disease-19 (COVID-19) in Saudi Arabia. Methods Patients were randomly selected from a COVID-19 database maintained by the Ministry of Health, Saudi Arabia. All patients were aged ≥60 years, had reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19, and were registered in the database during March 2020 to July 2020. Medical and sociodemographic characteristics were retrieved from the database. Additional data were collected by telephone interviews conducted by trained health professionals. Descriptive statistics and multiple logistic regression analyses were used to analyze the relationship between patient characteristics and the risk of hospitalization. Results Of the 613 included patients (51.1% females), more than half (57.3%) were between 60 to 69 years of age, and 53% (324/613) had been hospitalized. The independent predictors of hospitalization included age ≥65 years (OR = 2.35, 95% CI: 1.66–3.33, P < 0.001), having more than one comorbidity (OR = 1.55, 95% CI: 1.09–2.20, P = 0.01), diabetes mellitus (OR = 1.52, 95% CI: 1.09–2.11, P = 0.01), hypertension (OR = 1.40, 95% CI: 1.007–1.97, P = 0.04), chronic kidney disease (OR = 3.87, 95% CI: 1.41–10.58, P = 0.008), and history of hospital admission within the preceding year (OR = 1.69, 95% CI: 1.11–2.55, P = 0.013). Risk of hospitalization was lower in males (OR = 0.65, 95% CI: 0.43–0.90, P = 0.01) and in patients co-living with health care workers (OR = 0.64, 95% CI: 0.43–0.96, P = 0.03). Conclusion Factors associated with higher risk of COVID-19-associated hospitalization should be used in prioritizing older adults’ admission. Future studies with more robust designs should be conducted to examine the risk of COVID-19-associated illness severity and mortality.