Mohammad Alsultan | King Saud Bin Abdulaziz University for Health Sciences (original) (raw)

Papers by Mohammad Alsultan

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2011

To evaluate the utilization of critical care unit beds occupied by brain-dead patients during the... more To evaluate the utilization of critical care unit beds occupied by brain-dead patients during the period falling between confirmation of the diagnosis till, either, organ harvesting or patient's expiration. We studied all the consecutive patients who had been documented brain-dead from January 2001 to December 2009. Death by brain criteria was documented in 232 patients with a median age of 39 ± 18.2 years; 181 (78%) were Saudis and 175 (75.5%) were males. Only 37 deceased patients diagnosed by brain criteria were consented by their next-of-kin for organ donation; 26 (70.1%) of them were non-Saudis. The time from confirming death by brain criteria in the study patients until they were moved to a morgue or to the operating room for retrieval of organs were 93 ± 89.9 vs. 73 ± 48 h, respectively (P = 0.07). In conclusion, I believe a better utilization of the intensive care units' beds by other than brain-dead patients would not produce great cost savings, but may provide care ...

The American Journal of Clinical Nutrition, 2011

A105. RELATIONSHIP BETWEEN ICU STRUCTURES/PROCESSES AND OUTCOMES, 2010

A105 RELATIONSHIP BETWEEN ICU STRUCTURES/PROCESSES AND OUTCOMES 16/1:30 PM-4:00 PM / Room 255-257... more A105 RELATIONSHIP BETWEEN ICU STRUCTURES/PROCESSES AND OUTCOMES 16/1:30 PM-4:00 PM / Room 255-257 (Second Level), Morial Convention Center ... Comparison Between Crisis Resource Management Skills And Medical Knowledge For Critical Care ...

C24. IDENTIFYING PATIENTS AT RISK OF. . .AND RESCUING THEM, 2010

C24 IDENTIFYING PATIENTS AT RISK OF. . .AND RESCUING THEM AM-10:45 AM / Room 293-294 (Second Leve... more C24 IDENTIFYING PATIENTS AT RISK OF. . .AND RESCUING THEM AM-10:45 AM / Room 293-294 (Second Level), Morial Convention Center ... The Impact Of Implementing Critical Care Response Team (CCRT) On ICU Patient Mix And Outcomes ... , S. Qahtani , H. Tamim , ...

Middle East journal of anaesthesiology, 2013

Pheochromocytoma during pregnancy is extremely rare. Its clinical manifestation includes hyperten... more Pheochromocytoma during pregnancy is extremely rare. Its clinical manifestation includes hypertension with various clinical presentations, possibly resembling those of pregnancy-induced hypertension. The real challenge for clinicians is differentiating pheochromocytoma from other causes of hypertension (preeclampsia, gestational hypertension, and pre-existing or essential hypertension), from other cause of pulmonary edema (preeclampsia, peripartum cardiomyopathy, stress or Takotsubo cardiomyopathy, pre-existing cardiac disease [mitral stenosis], and high doses betamimetics), and from other causes of cardiovascular collapse (pulmonary embolism, and amniotic fluid embolism). Although, several cases of pheochromocytoma during pregnancy have been published, fetal and maternal mortalities due to undiagnosed cases are still reported. We report a case of a patient whose delivery by cesarean section was complicated by severe hemodynamic instability resulting in a cardiac arrest. Later on, p...

American Journal of …, 2009

A92 FIVE RANDOMIZED CLINICAL TRIALS WITH EDITORIAL DISCUSSION / Mini Symposium / Sunday, May 17/1... more A92 FIVE RANDOMIZED CLINICAL TRIALS WITH EDITORIAL DISCUSSION / Mini Symposium / Sunday, May 17/1:30 PM−4:00 PM / Room 11 A−B (Upper Level) San Diego Convention Center ... Permissive Underfeeding Versus Target Feeding in Critically Ill Patients: Randomized ...

Background: The demand for critical care beds is increasing out of proportion to bed availability... more Background: The demand for critical care beds is increasing out of proportion to bed availability. As a result, some critically ill patients are kept in the Emergency Department (ED boarding) awaiting bed availability. The aim of our study is to examine the impact of boarding in the ED on the outcome of patients admitted to the Intensive Care Unit(ICU). Methods: This was a retrospective analysis of ICU data collected prospectively at King Abdulaziz Medical City, Riyadh from ED between January 2010 and December 2012 and all patients admitted during this time were evaluated for their duration of boarding. Patients were stratified into three groups according to the duration of boarding from ED. Those admitted less than 6 h were classified as Group I, between 6 and 24 h, Group II and more than 24 h as Group III. We carried out multivariate analysis to examine the independent association of boarding time with the outcome adjusting for variables like age, sex, APACHE, Mechanical ventilation, Creatinine, Platelets, INR. Results: During the study period, 940 patients were admitted from the ED to ICU, amongst whom 227 (25%) were admitted to ICU within 6 h, 358 (39%) within 6-24 h and 355 (38%) after 24 h. Patients admitted to ICU within 6 h were younger [48.7 ± 22.2(group I) years, 50.6 ± 22.6 (group II), 58.2 ± 20.9 (group III) (P = 0.04)]with less mechanical ventilation duration[5.9 ± 8.9 days (Group I), 6.5 ± 8.1 (Group II) and 10.6 ± 10.5 (Group III), P = 0.04]. There was a significant increase in hospital mortality [51(22.5), 104(29.1), 132(37.2), P = 0.0006) and the ICU length of stay(LOS) [9.55 days (Group I), 9.8 (Group II) and 10.6 (Group III), (P = 0.002)] with increase in boarding duration. In addition, the delay in admission was an independent risk factor for ICU mortality(OR for group III vs group I is 1.90, P = 0.04) and hospital mortality(OR for group III vs Group I is 2.09, P = 0.007). Conclusion: Boarding in the ED is associated with higher mortality. This data highlights the importance of this phenomenon and suggests the need for urgent measures to reduce boarding and to improve patient flow.

Anaesthesia and intensive care

Our aim was to evaluate end-of-life practices in a tertiary intensive care unit in Saudi Arabia. ... more Our aim was to evaluate end-of-life practices in a tertiary intensive care unit in Saudi Arabia. A prospective observational study was conducted in the medical-surgical intensive care unit of a teaching hospital in Riyadh, Saudi Arabia. Over the course of the one-year study period, 176 patients died and 77% of these deaths were preceded by end-of-life decisions. Of these, 66% made do-not-resuscitate decisions, 30% decided to withhold life support and 4% withdrew life support. These decisions were made after a median time of four days (Q1 to Q3: 1 to 9) and at least one day before death (Q1 to Q3: 1 to 4). The patients' families or surrogates were informed for 88% of the decisions and all decisions were documented in the patients' medical records. Despite religious and cultural values, more than three-quarters of the patients whose deaths were preceded by end-of-life decisions gave do-not-resuscitate decisions before death. These decisions should be made early in the patients...

Saudi Journal of Kidney Diseases and Transplantation, 2012

The growing demand for organs continues to outpace the supply. The aim of our study was to evalua... more The growing demand for organs continues to outpace the supply. The aim of our study was to evaluate the knowledge, attitude and awareness of organ donation procedures among the health-care providers in the Intensive Care Units (ICUs) at a tertiary hospital. This was a questionnaire-based study conducted in December 2011 among the health-care providers at five ICUs in a tertiary teaching hospital in Riyadh, Saudi Arabia. A total of 154 participants completed the questionnaire. Eighty percent of the participants acknowledged that organ donation is a legal practice in Saudi Arabia, but only 73% knew that the hospital had an organ donation policy. However, only 34% were willing to participate in a training program for organ donation. Interestingly, only 57% were willing to donate their organs. Our results suggest that more measures should be taken to educate the health-care providers regarding the concept of organ donation and the ethical and religious beliefs. Also, the policy of the hospital and the Saudi Center for Organ Transplantation regarding the process of organ donation should be strongly emphasized.

Annals of Saudi medicine

Trauma is a leading cause of death worldwide and in Saudi Arabia. This study describes the injury... more Trauma is a leading cause of death worldwide and in Saudi Arabia. This study describes the injury profiles and ICU outcomes of patients in a tertiary trauma care referral center in Riyadh, Saudi Arabia. A retrospective analysis of ICU data collected prospectively over 5 years in a 21-bed medical and surgical intensive care unit (ICU) in a tertiary care teaching hospital. We collected ICU data on all patients admitted secondary to motor vehicle accidents (MVAs), excluding patients younger than 18 years, brain dead patients and readmissions. We collected data on age, gender, and Glasgow coma scale score at admission, injury severity scores, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and other data. Multivariate logistic regression was used to identify predictors of mortality. During the study period, of 1659 patients, MVA was the most common cause of injury (78.4%), followed by pedestrian accident (12.7%). ICU mortality included 221 patients (13.3%) during th...

Thrombosis Journal, 2011

Background: Cirrhotic patients are characterized by a decreased synthesis of coagulation and anti... more Background: Cirrhotic patients are characterized by a decreased synthesis of coagulation and anticoagulation factors. The coagulopathy of cirrhotic patients is considered to be auto-anticoagulation. Our aim was to determine the incidence and predictors of venous thromboembolism (VTE) and examine the practice of deep venous thrombosis (DVT) prophylaxis among hospitalized cirrhotic patients. Methods: A retrospective cohort study was performed in a tertiary teaching hospital. We included all adult patients admitted to the hospital with a diagnosis of liver cirrhosis from We grouped our cohort patients in two groups, cirrhotic patients without VTE and cirrhotic with VTE.

Saudi Journal of Gastroenterology, 2011

To determine the mortality rate in a cohort of hospitalized patients with cirrhosis and examine t... more To determine the mortality rate in a cohort of hospitalized patients with cirrhosis and examine their resuscitation status at admission. A retrospective chart review was conducted of patients with cirrhosis who were admitted to a tertiary care hospital in Riyadh, Saudi Arabia, from January 1, 2009, to December 31, 2009. We reviewed 226 cirrhotic patients during the study period. The hospital mortality rate was 35%. A univariate analysis revealed that worse outcomes were seen in patients with advanced age or who had worse child-turcotte-pugh (CPT) scores, worse model for end-stage liver disease (MELD) scores, low albumin and high serum creatinine. Using a multivariate analysis, we found that advanced age (P=0.004) and high MELD (P=0.001) scores were independent risk factors for the mortality of cirrhotic patients. The end-of-life decision were made in 34% of cirrhotic patients, and the majority of deceased patients were &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;no resuscitation&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; status (90% vs. 4%, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). The relatively high mortality in cirrhotic patients admitted for care in a tertiary hospital, Saudi Arabia was comparable to that reported in the literature. Furthermore, end-of-life discussions should be addressed early in the hospitalization of cirrhotic patients.

BMC Medical Education, 2008

Background: Medical education in Saudi Arabia is facing multiple challenges, including the rapid ... more Background: Medical education in Saudi Arabia is facing multiple challenges, including the rapid increase in the number of medical schools over a short period of time, the influx of foreign medical graduates to work in Saudi Arabia, the award of scholarships to hundreds of students to study medicine in various countries, and the absence of published national guidelines for minimal acceptable competencies of a medical graduate.