Objectives: To improve the understanding of the association between electrocardiographic)ECG(abnormalities and clinical outcomes of patients with all types of intracranial hemorrhage)ICH(. Methods: A retrospective cohort study was conducted in a tertiary healthcare hospital on patients with ICH without cardiac disease or renal disease requiring dialysis. Demographic and clinical data were collected from hospital records. ECG record were Original Article obtained within 24 hours of presentation and prior to treatment. Records were interpreted for this study by a cardiologist blinded to other data. Results: Assessment of 291 patients)228 adults and 63 children(showed that subdural hemorrhage was the most common type of ICH)31.6%(followed by intraparenchymal hemorrhage)23.0%(. ECG records were available for 98 patients. ECG abnormalities were most commonly nonspecific ST-segment changes)32.6%(. In adults, history of neurological disease was associated with atrioventricular block)p=.004(and QTc prolongation)p=.041(. Pediatric patients exhibited associations between ST-segment changes)p=.045(and sinus tachycardia)p=.027(and type of ICH. However, ECG changes were not statistically associated with clinical outcomes in adults or children. Conclusion: Significant ECG changes frequently occurred in patients with all types of ICH but did not consistently predict the outcome in this study. Close observation of patients is still recommended to detect ECG changes that could affect the treatment.
Background: Temporary stoma formation for fecal diversion is commonly performed in surgery. The rate of stoma-related complications is high, and the risk increases in patients with prolonged time to closure. Thus, identifying factors that influence the time to stoma closure and the rate of its complications would aid in implementing preventive measures. We aimed to determine predictors affecting the time to stoma closure and to identify risk factors for developing complications following stoma reversal.Methods: A retrospective review including all adult patients who underwent stoma closure from 2012-2018 at our institution was conducted. Multivariate regression analysis was used to determine risk factors affecting time to stoma closure and developing complications after reversal surgery.Results: A total of 63 patients were included. Of those, 50.8% were diagnosed with malignancy. The median time to stoma closure was 222.5 days (interquartile range i.e. IQR 12-2228).Having an American society of anesthesiologists (ASA) class IV was the only significant predictor of prolonged time to closure. For cancer patients, developing complications following stoma formation surgery, and receiving adjuvant therapy significantly increased the time to stoma reversal. In contrast, cancer patients who underwent multi-organ resection had shorter time to closure. The rate of complications following stoma reversal was 30.2%. Having a colostomy and requiring readmission after stoma formation surgery increased the risk of developing complications related to stoma reversal.Conclusions: Multiple factors can impact the time to stoma closure and increase the risk of developing complication related to stoma closure. Awareness about these factors and development of preventive strategies is recommended.
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