Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality ). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.

Background:Cardiovascular Disease (CVD) is considered as the main cause of death worldwide. Identifying the links among CVDs risk factors can help decrease CVD-related deaths.Aim:To assess the prevalence of risk factors for CVD and their relationships among the Tabuk City population in Saudi Arabia.Methods:A cross-sectional design was used; 432 participants in the Tabuk region were included in this study.Results:The prevalence of diabetes mellitus (DM) was 5.6%, the prevalence of hypertension (HTN) was 11.1% and obesity and overweight together were 69.9%. Mean Body Mass Index (BMI), HTN, and DM increased with age. There was a correlation between BMI with HTN (r=.200, p<.001), BMI and DM (r=.149, p<.001) and DM and HTN (r=.366, p<.001).Conclusion:Public awareness may help in reducing the prevalence of CVD.

Patients on maintenance hemodialysis are subjected to mild-to-moderate pain associated with arteriovenous fistula needle insertion. This pain might adversely affect patient compliance with dialysis and quality of life. The aim of this study was to evaluate published research studies on management strategies for pain associated with fistula needle insertion. A review of 35 studies from well-known databases such as CINAHL, ProQuest, and PubMed was conducted. Three strategies of cannulation pain management were found to have been tried: specific cannulation techniques; use of alternative complementary therapies; and use of local anesthetic agents.

Job satisfaction improves the outcome of health care services. Nurses' job satisfaction should receive more attention in Saudi Arabia, and worldwide. This study was undertaken to measure factors that affect job satisfaction among critical care nurses at King Khalid Hospital in Saudi Arabia. This study used a quantitative, cross-sectional method. A convenient sample of 190 critical care nurses was recruited from the main government hospital in Saudi Arabia. Job satisfaction scales were used in this study. Overall, the staff nurses were neither satisfied nor dissatisfied with their work. The majority of participating nurses were moderately satisfied with their relationships with coworkers (mean = 4.24, standard deviation [SD] = 1.66) and nature of their jobs (mean = 4.13, SD = 0.74). Their lowest satisfaction scores were related to communication (mean = 3.42, SD = 0.82), followed by pay (mean = 3.7, SD = 0.65), and supervision (mean = 3.75, SD = 0.55). Job satisfaction of staff nurses is marginal. This calls for leadership intervention. Decision-makers must consider this when adopting new policies to enhance nurses' job satisfaction.