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Mohammad Sarani , Zahra Shahraki , Mahboobeh Shirazi , Soleiman Saravani ,
Volume 72, Issue 9 (12-2014)
Volume 72, Issue 9 (12-2014)
Abstract
Background: Maternal mortality is one of the most important indicators of women health standard in developing countries. This study aimed to determine the prevalence of risk factors and etiology of maternal mortality in a geographic region of Iran. Methods: This descriptive- analytic cross sectional study included all pregnant women who died during pregnancy and six weeks after delivery due to pregnancy related fac-tor. The study was done in Sistan region in the north of Sistan and Baluchestan Prov-ince of Iran from April 2002 to March 2014. The immigrant women were excluded. Data were collected using 3 parts questionnaire. The validity and reliability of ques-tioner were approved by experts in this field. Data were analyzed using the statistical software SPSS version 18, Chi-square test and ANOVA analysis were performed. Results: The total number of deliveries during this time period was 60496. The total number of maternal mortality was 57 patients which means 94.2 out of 100.000 live births. Most of the dead mothers had more than 35 years old (46.9%), gestational age was more than 22 weeks (77.2%), gravidity more than 4 (21.1%), pregnancy interval lower than two years (46.9%) and 75.4% of death was in post-partum. The main cause of mortality was post-partum hemorrhage (19.3%). Conclusion: Based on our findings, some factors including multiparity, pregnancy his-tory more than 4 times, short interval between pregnancies lower than 2 years and ma-ternal age more than 35 years were some risk factors for maternal death. Maternal mortality in the postpartum period was more than pre-delivery period. Bleeding was the main cause of maternal mortality. Therefore monitoring of vital signs in the post-partum period and the proper management of bleeding are very important. It is sug-gested that risk assessment should be done for pregnant women in delivery ward for detecting high risk pregnant women. Suitable management for these women especially for patients with postpartum hemorrhage plays an important role to decrease the ma-ternal mortality.
Mohammad Ali Heidarnia , Alireza Abadi , Mohamad Fsmaeil Motlagh, Mohammad Heidarzadeh , Abbas Habibelahi , Farima Raji ,
Volume 74, Issue 7 (10-2016)
Volume 74, Issue 7 (10-2016)
Abstract
Background: The first duty of any government is to ensure the health of its children and neonates. Today's countries are classified as declining mortality in this group. To increase neonatal survival rate, classified causes of newborn mortality are the core strategy and policies. This study was aimed to determine the classification of causes of neonatal death in Iran.
Methods: Neonatal mortality refers to deaths of young children. It is measured by the neonatal mortality rate (NMR), which is the number of deaths of neonates per 1000 live births. This study was used data from 11693 neonatal deaths (from 22 weeks gestational age to neonatal death less than 30 days), in Iran's hospitals in 2012 that registered in the perinatal mortality surveillance system (hospital-based system). Demographic characteristics and other factors associated with neonatal death were investigated. To aid in cause of death analysis, burden of disease analysis, and comparative risk assessment we classified the causes of death according to international statistical classification of diseases version 10 (ICD 10), divided into three cause mortality strata.
Results: Results showed the most common cause of neonatal mortality was "certain conditions originating in the perinatal period" (77.92%) with the highest incidence of "disorders related to length of gestation and fetal growth" (37.7%) in this group. Also it shows that 20.82% of deaths caused by "congenital malformations, deformations and chromosomal abnormalities" and 1.26% cases had occurred as a result of "accidents and injuries". The greatest cause of death in the neonates with weight over one thousand grams was "certain conditions originating in the perinatal period" (71.29%), with the highest percentage in the disorders related to "length of gestation and fetal growth" (29.65%).
Conclusion: According to this study the "certain conditions originating in the perinatal period" special "disorders related to length of gestation and fetal growth" was the main cause of neonatal mortality. Also "congenital malformations, deformations and chromosomal abnormalities" was the second cause of neonatal mortality.
Hassan Babamohamadi , Abbasali Ebrahimian , Fateme Paknazar , Hojat Torkamandi ,
Volume 74, Issue 7 (10-2016)
Volume 74, Issue 7 (10-2016)
Abstract
Background: The ability to recognize the severity of the disease in those who their survival depend entirely on admission to the intensive care unit, is very valuable clinically. This study aimed to evaluate the clinical effectiveness of modified sequential organ failure assessment (MSOFA) scale to predict mortality and length of stay in intensive care unit patients respectively.
Methods: This was a retrospective cross-sectional study conducted on hospital records of patients admitted to the intensive care unit. All patients’ records who admitted to the intensive care unit of Kowsar Hospital, Semnan city (the capital of the province), Iran, in 2015 considered as the sample. Collecting data were done during 4 weeks in April and May 2016. The data collection tool was a demographic questionnaire and modified sequential organ failure assessment scale. Exclusion criteria included discharge in the first 24 hours after admission, the patient died a few hours after admission and incomplete information to complete the modified sequential organ failure assessment form.
Results: The study of 105 patients' records of the intensive care unit showed that 45.7% of patients were died, 15.2% and 39% were discharged and moved to other wards respectively. The results of logistic regression analysis and receiver operating characteristic (ROC) curve showed that this criterion had moderate sensitivity and specificity for prediction of mortality and length of stay in ICU patients (Area=0.635, CI= 0.527-0.743) and each unit increase in modified sequential organ failure assessment score is accompanied by increasing 32 percent chance of death (OR=1.325; 95% CI:1.129,1.555; P= 0.001(. Also each unit increase in modified sequential organ failure assessment (MSOFA) score accompanied by increasing 19% length of stay in ICU (OR=1.191; 95% CI: 1.034, 1.371; P= 0.015(.
Conclusion: The results of this study showed that the modified sequential organ failure assessment scale is not useful tool to predict the length of stay and mortality of patients admitted to the intensive care unit.
Majid Kermani , Mohsen Dowlati , Ahmad Jonidi Jafari , Roshanak Rezaei Kalantari ,
Volume 74, Issue 12 (3-2017)
Volume 74, Issue 12 (3-2017)
Abstract
Background: Air pollution, especially the phenomenon of dust and particulate matter can cause mortality of many civilians, and causes various diseases including cardiovascular and respiratory diseases. One of the major pollutants in the air is particulate matter that concentration has increased over recent years. So, present study with aim of Quantification Health Endpoints Attributed to particulate matter in Tehran, Capital of Iran during the past decade (2005-2014) by AirQ software, version 2.2.3 (WHO European Centre for Environment and Health) was performed.
Methods: This study is a descriptive-analytic investigation. The process of performance this study lasted 12 months. Subject of this the study and research was in Environmental Health Engineering Department of Iran University of Medical Sciences. Exact data of every hour pollutants were taken from Department of environmental (DOE) Islamic Republic Iran and Air Quality Control Company of Tehran. Then validated according to the World Health Organization (WHO) guidelines and Statistical parameters for quantifying health effects were calculated in excel software. Finally, assessment of cases total mortality, cardiovascular mortality, respiratory mortality and cardiovascular disease and respiratory disease, with AirQ software was performed.
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Results: The results of this study showed that the number of total mortality, cardiovascular mortality and respiratory mortality caused by exposure to Particulate matter smaller than 10 microns (PM10) in the past decade is 11776, 12121 and 33066 cases respectively. Also the total number of hospital admission due to cardiovascular disease and respiratory disease in the past decade is 20990 and 54352 cases in 2005-2014 years. Conclusion: According to the results of this study, during the last decade the level of air pollution and Concentration of pollutants in Tehran Increased. Effects and health consequences due to exposure to Particulate matter smaller than 10 microns (PM10) in Tehran Metropolis Is very severe and increased mortality and cardiovascular and respiratory diseases among the citizens of Tehran. |
Babak Mostafazadeh , Mohammad Hosien Kamaloddini , Fares Najari ,
Volume 75, Issue 6 (9-2017)
Volume 75, Issue 6 (9-2017)
Abstract
Background: The death certificate is a document consisting of the deceased individual’s basic information and identification which is filled out, registered and signed by a doctor. the World health organization’s policies in their health planning, provide a suitable database with knowledge of the required elements for planners and other authorized information demanders. During a multi-year cooperation between various organizations, the first uniformed death certificate according the ICD-10 standard got published in the country in the year 2004.
Methods: This is a retrospective study which is about all of the deceased individuals in Tajrish and Modares Tehran hospitals from april 2013 until the march 2014 who had death certificates. In this study the data related to 777 individual’s death certificates and medical files was analyzed. The sampling method was census and all the cases in the study’s time period who had death certificates were studied. The cases that had a gap in their required information were ruled out of the study. The data that included age, sex, place of death, issuing doctor’s expertise, general information and the cause of death was extracted from the archived files.
Methods: This is a retrospective study which is about all of the deceased individuals in Tajrish and Modares Tehran hospitals from april 2013 until the march 2014 who had death certificates. In this study the data related to 777 individual’s death certificates and medical files was analyzed. The sampling method was census and all the cases in the study’s time period who had death certificates were studied. The cases that had a gap in their required information were ruled out of the study. The data that included age, sex, place of death, issuing doctor’s expertise, general information and the cause of death was extracted from the archived files.
| Results: The cases studied, 421 people died in Tajrish Hospital and 356 in Modarres Hospital. The highest number of deaths in both hospitals were in the internal wards (336 cases) and surgery (168 people). 45.6% of death certificates have been issued by a forensic expert. 64.8% cases correctly inserted ICD-10 code. Conclusion: Training of physicians for the importance of death certificate and how it should be completed is very important. This research showed that in the cases which the death certificates were completed by the hospital forensic medicine specialists were more useful and accurate. |
Alireza Atashi , Shahram Amini , Erfan Ghasemi , Shima Sheybani , Saeid Eslami ,
Volume 76, Issue 4 (7-2018)
Volume 76, Issue 4 (7-2018)
Abstract
Background: Various prediction models have been developed aiming to estimate risk-adjusted mortality, morbidity and length of intensive care unit stay following cardiac surgeries. The European system for cardiac operative risk evaluation II (EuroSCORE II) is a prediction model which maps 18 predictors to a 30-day post-operative risk of death. The objective of this study was to evaluate the performance of the EuroSCORE II risk-analysis predictions among patients who underwent heart surgeries.
Methods: A prospective cross-sectional study was conducted to collect required variables for all consecutive patients underwent heart surgeries in Emam Reza hospital, Mashhad, Iran, from March 2014 to March 2015. Once the patient was hospitalized a cardiologist or a general physician evaluated pre- peri- and post-operative state to fill out the pre-designed structural paper form. Comparing the observed and expected mortality, the sensitivity, specificity, area under the receiver operating characteristic curve (AUC) and finally the discrimination power of the model for our patients were calculated and reported. The model value was calculated using the online tool.
Results: A total of 1337 patients (60% males) were included, the observed mortality rate was 3.2%. Although the overall performance was acceptable, the model showed poor discriminatory power (AUC=0.667, CI 95%: 0.648-0.685) and accuracy with sensitivity=61.88% and specificity=66.23%.
Conclusion: Our single-center study, based on consecutive patients who underwent cardiac surgery showed that EuroSCORE II demonstrated a moderate statistical overall performance with poor discrimination and calibration measures remain as concerning issues regarding 30-day post-operative mortality prediction after adult cardiac surgery. Poor performance measures for this system show the need for reformulating this risk stratification tool aiming to improve post cardiac surgery outcome predictions in Iran.
Methods: A prospective cross-sectional study was conducted to collect required variables for all consecutive patients underwent heart surgeries in Emam Reza hospital, Mashhad, Iran, from March 2014 to March 2015. Once the patient was hospitalized a cardiologist or a general physician evaluated pre- peri- and post-operative state to fill out the pre-designed structural paper form. Comparing the observed and expected mortality, the sensitivity, specificity, area under the receiver operating characteristic curve (AUC) and finally the discrimination power of the model for our patients were calculated and reported. The model value was calculated using the online tool.
Results: A total of 1337 patients (60% males) were included, the observed mortality rate was 3.2%. Although the overall performance was acceptable, the model showed poor discriminatory power (AUC=0.667, CI 95%: 0.648-0.685) and accuracy with sensitivity=61.88% and specificity=66.23%.
Conclusion: Our single-center study, based on consecutive patients who underwent cardiac surgery showed that EuroSCORE II demonstrated a moderate statistical overall performance with poor discrimination and calibration measures remain as concerning issues regarding 30-day post-operative mortality prediction after adult cardiac surgery. Poor performance measures for this system show the need for reformulating this risk stratification tool aiming to improve post cardiac surgery outcome predictions in Iran.
Rostam Zalvand, Mehdi Yaseri, Ali Mohammad Mosadeghrad , Maryam Tajvar,
Volume 77, Issue 2 (5-2019)
Volume 77, Issue 2 (5-2019)
Abstract
Background: Identifying determinants of maternal mortality is essential in developing appropriate health policies for reduction of maternal death. This study aimed to determine the determinants of maternal mortality in Iran during 1990- 2015 and also to identify the trends of these determinants during the same period.
Methods: This is a quantitative longitudinal study that has been conducted at the Tehran University of Medical Science, Iran, from March to December 2018. Initially, a long list of determinants (n=32) were identified through a comprehensive systematic reviews. Variables with more than 25% missing data were omitted and the missing values for remaining variables were estimated through statistical methods. The data for the identified variables were gathered through internal sources including Iran’s Ministry of Health and international sources including the websites of World Bank, World Health Organization and United Nations. Finally, 12 indicators as determinants of death were constructed after data processing and data management and their associations with maternal mortality rate in Iran were examined through regression analysis.
Results: Maternal mortality rate has been reduced by 80% during 1990- 2015 in Iran. Improvement of indicators including employment status, total health expenditure share (as a percent of GDP), vaccination coverage, urbanization, access to health and welfare facilities, GDP per capita and political performance played a significant role in reduction of maternal deaths according to the multivariate analyses. A reduction in out of pocket payment and total fertility rate also showed a significant association with lower maternal mortality. However neither education level in the country nor life expectancy at birth showed an important role in the maternal mortality rate.
Conclusion: Maternal mortality rate was reduced significantly in Iran during the last quarter of the century. Maternal death is not only affected by health and biological factors of mothers, but also, by macro-economic, social and welfare factors. A high political performance of the countries also is a grantor of better health of mothers and the community in general.
Methods: This is a quantitative longitudinal study that has been conducted at the Tehran University of Medical Science, Iran, from March to December 2018. Initially, a long list of determinants (n=32) were identified through a comprehensive systematic reviews. Variables with more than 25% missing data were omitted and the missing values for remaining variables were estimated through statistical methods. The data for the identified variables were gathered through internal sources including Iran’s Ministry of Health and international sources including the websites of World Bank, World Health Organization and United Nations. Finally, 12 indicators as determinants of death were constructed after data processing and data management and their associations with maternal mortality rate in Iran were examined through regression analysis.
Results: Maternal mortality rate has been reduced by 80% during 1990- 2015 in Iran. Improvement of indicators including employment status, total health expenditure share (as a percent of GDP), vaccination coverage, urbanization, access to health and welfare facilities, GDP per capita and political performance played a significant role in reduction of maternal deaths according to the multivariate analyses. A reduction in out of pocket payment and total fertility rate also showed a significant association with lower maternal mortality. However neither education level in the country nor life expectancy at birth showed an important role in the maternal mortality rate.
Conclusion: Maternal mortality rate was reduced significantly in Iran during the last quarter of the century. Maternal death is not only affected by health and biological factors of mothers, but also, by macro-economic, social and welfare factors. A high political performance of the countries also is a grantor of better health of mothers and the community in general.
Khadije Saravani , Mohammad Hossien Kamaloddini , Mahboobe Asgari ,
Volume 77, Issue 7 (10-2019)
Volume 77, Issue 7 (10-2019)
Abstract
Background: Determination of mortality causes precisely, is very important in developing countries. Mortality rate is a helpful index for evaluating the quality of health in every society. However, recording of life events as well as mortality rates are difficult and conducted only in a few developing countries which account for a large percentage of the world’s mortality. Thus, it was attempted to conduct a study on mortality cases of under 18 year’s old corpses referred to the dissection laboratory of forensic medicine in Tehran from 2014 to 2015.
Methods: In this cross-sectional descriptive study, all cases of accidental deaths less than 18 years old which were referred to forensic medicine in Tehran have examined. All mortality data between April 2014 and April 2015 was completed by a questionnaire. This data were classified by age, sex, cause of referral, type of death, underlying disease, and cause of death based on autopsy results and positive findings of autopsy, pathology, and toxicology.
Results: In 2014 and 2015, 495 and 508 cases of under 18 years old were sent to the dissection laboratory of forensic medicine in Tehran, consequently. The mortality rate of 520 males and 483 females was recorded and it has risen from 2014 to 2015. The most common mortality causes are accidents, suspicious death, suicide, and car accidents.
Conclusion: The results showed that the mortality rate in males was higher than females, which is in line with the global findings. This may be due to cultural issues or the vulnerability of males. Study on causes of deaths, which recorded over two years showed that deaths in Tehran province are due to accidents, falls, strangulation, life-threatening poisoning and electrocution, birth disorders and suicides, which requires more studies on these subjects.
Methods: In this cross-sectional descriptive study, all cases of accidental deaths less than 18 years old which were referred to forensic medicine in Tehran have examined. All mortality data between April 2014 and April 2015 was completed by a questionnaire. This data were classified by age, sex, cause of referral, type of death, underlying disease, and cause of death based on autopsy results and positive findings of autopsy, pathology, and toxicology.
Results: In 2014 and 2015, 495 and 508 cases of under 18 years old were sent to the dissection laboratory of forensic medicine in Tehran, consequently. The mortality rate of 520 males and 483 females was recorded and it has risen from 2014 to 2015. The most common mortality causes are accidents, suspicious death, suicide, and car accidents.
Conclusion: The results showed that the mortality rate in males was higher than females, which is in line with the global findings. This may be due to cultural issues or the vulnerability of males. Study on causes of deaths, which recorded over two years showed that deaths in Tehran province are due to accidents, falls, strangulation, life-threatening poisoning and electrocution, birth disorders and suicides, which requires more studies on these subjects.
Masoud Mohammadi , Ali Akbar Vaisi-Raygani , Rostam Jalali , Akram Ghobadi , Nader Salari , Mitra Hemmati ,
Volume 77, Issue 9 (12-2019)
Volume 77, Issue 9 (12-2019)
Abstract
Background: Infant mortality is important as a standard indicator for the development of health, educational and social health systems in each country. Considering the fact that in different studies of the country there are different statistics on the prevalence of infant mortality in the intensive care unit and the general statistics on the prevalence of mortality in neonates in the country are unclear and unclear, the aim of this study was systematic review and meta-analysis for determine the prevalence of mortality in infants admitted to the intensive care unit (ICU) of hospitals in Iran.
Methods: A meta-analysis was performed for relevant articles in scientific databases including scientific information database (SID) and Magiran, ScienceDirect, Scopus, Medline (PubMed) and Google Scholar. Entrance criteria included cross-sectional studies between March 2000 to September 2018. The search process in these databases was performed using keywords: Neonatal, Intensive Care Unit, Mortality, and Iran. Non-relevant articles included review articles, interventions, cohorts and case-control studies, excluded from the study list. Heterogeneity of study was checked using I2 index and the possibility of publication bias by funnel plot and Egger test. Data were analyzed using the comprehensive meta-analysis software, version 3 (Biostat, Englewood, NJ, USA).
Results: The overall prevalence of infant mortality in ICU hospitals was 21.8% (95% CI 14.4-31.6%), the highest prevalence of infant mortality in Isfahan was 64.4% percentage (95% CI 57.5-70.9%) and the lowest mortality rate in babies in Babol's intensive care unit with 5.1% (95% CI 3.8-6.7%). The results of the study showed that the prevalence of infant mortality was significantly reduced with increasing sample size (P<0.05). Also, with an increase in years of research, the frequency of infant mortality in the intensive care unit increases, which is also statistically significant respectively (P<0.05).
Conclusion: Considering the high prevalence of infant mortality in ICU hospitals in Iran, health policy makers need to take effective measures to raise awareness of parents as well as effective measures to reduce infant mortality.
Methods: A meta-analysis was performed for relevant articles in scientific databases including scientific information database (SID) and Magiran, ScienceDirect, Scopus, Medline (PubMed) and Google Scholar. Entrance criteria included cross-sectional studies between March 2000 to September 2018. The search process in these databases was performed using keywords: Neonatal, Intensive Care Unit, Mortality, and Iran. Non-relevant articles included review articles, interventions, cohorts and case-control studies, excluded from the study list. Heterogeneity of study was checked using I2 index and the possibility of publication bias by funnel plot and Egger test. Data were analyzed using the comprehensive meta-analysis software, version 3 (Biostat, Englewood, NJ, USA).
Results: The overall prevalence of infant mortality in ICU hospitals was 21.8% (95% CI 14.4-31.6%), the highest prevalence of infant mortality in Isfahan was 64.4% percentage (95% CI 57.5-70.9%) and the lowest mortality rate in babies in Babol's intensive care unit with 5.1% (95% CI 3.8-6.7%). The results of the study showed that the prevalence of infant mortality was significantly reduced with increasing sample size (P<0.05). Also, with an increase in years of research, the frequency of infant mortality in the intensive care unit increases, which is also statistically significant respectively (P<0.05).
Conclusion: Considering the high prevalence of infant mortality in ICU hospitals in Iran, health policy makers need to take effective measures to raise awareness of parents as well as effective measures to reduce infant mortality.
Saied Bokaie , Hessameddin Akbarein , Behnaz Beygi , Ehsan Mosa Farkhani ,
Volume 78, Issue 1 (4-2020)
Volume 78, Issue 1 (4-2020)
Abstract
Background: Today, due to changes in human lifestyle and consumer demand incidence of foodborne diseases is on the rise. The aim of this study was to investigate the mortality rate of foodborne diseases and their related factors.
Methods: In this cross-sectional study, data on deaths registered according to the International Classification of Diseases (ICD-10th revision) were extracted from death registration and classification of causes system in the Ministry of Health and Medical Education of Iran from 2011 to 2018. Data on deaths from food and water borne diseases including Salmonella, Shigella, Escherichia coli O157:H7, Staphylococcus aureus, Clostridium botulinum, and other foodborne diseases were extracted from database of death registration and classification of causes system. The demographic variables of dead people considered in this study include age (under 5 years, 5-20 years, 20-40, 40-60s and over 60 old), gender, nationality, and the location where people died (urban, rural and unknown).
Results: The majority of deaths cases occurred at the age of 60 years and in older age groups (P<0.001). The results show that across all the age groups mortality rate from foodborne diseases was higher among men than among women (P=0.110). Most of foodborne diseases were reported by people living in urban areas (P<0.0001). The results of this study showed that most of the deaths from these diseases occur in the warm seasons. In this study, the crude death rate was 10 cases per one million inhabitants.
Conclusion: The results of this study showed that there was a significant difference between the mortality rate due to different bacterial agents. This study suggests that demographic variables are important predictors of mortality from foodborne illness and should be further investigated.
Methods: In this cross-sectional study, data on deaths registered according to the International Classification of Diseases (ICD-10th revision) were extracted from death registration and classification of causes system in the Ministry of Health and Medical Education of Iran from 2011 to 2018. Data on deaths from food and water borne diseases including Salmonella, Shigella, Escherichia coli O157:H7, Staphylococcus aureus, Clostridium botulinum, and other foodborne diseases were extracted from database of death registration and classification of causes system. The demographic variables of dead people considered in this study include age (under 5 years, 5-20 years, 20-40, 40-60s and over 60 old), gender, nationality, and the location where people died (urban, rural and unknown).
Results: The majority of deaths cases occurred at the age of 60 years and in older age groups (P<0.001). The results show that across all the age groups mortality rate from foodborne diseases was higher among men than among women (P=0.110). Most of foodborne diseases were reported by people living in urban areas (P<0.0001). The results of this study showed that most of the deaths from these diseases occur in the warm seasons. In this study, the crude death rate was 10 cases per one million inhabitants.
Conclusion: The results of this study showed that there was a significant difference between the mortality rate due to different bacterial agents. This study suggests that demographic variables are important predictors of mortality from foodborne illness and should be further investigated.
Saeed Nateghi, Forough Goudarzi , Samad Taghavi Namin , Atefeh Rasouli , Akram Khalili Noushabadi, Safieh Mohammadnejhad ,
Volume 79, Issue 9 (12-2021)
Volume 79, Issue 9 (12-2021)
Abstract
Background: Age is a strong risk factor for increasing the risk of severity and death from Covid-19. The risk of hospitalization for Covid-19 disease increases with age. Since the elderly constitute a large proportion of Covid-19 patients, the present study was performed to evaluate the severity of the disease in the hospitalized elderly due to Covid-19 and the delay in hospitalization and death resulting from it, for better disease management.
Methods: The present retrospective cohort study was performed on 444 elderly patients with Covid-19 admitted from 1 April until late October 2020 in Baharloo Hospital in Tehran, Iran. After being diagnosed using the results of RT-PCR and CT scan, patients, were divided into 3 groups: moderate, severe and very severe based on the severity of the disease. Analysis of variance was used to compare quantitative data and a chi-square test was used to examine qualitative variables in disease groups.
Results: From 444 elderly participants in the study, 73% were infected moderately, 15% severely, and 12% had a very severe form. The mean age was 72.90±8.42 and patients with a very severe form of the disease (75.68±8.28) were older. The average time from the onset of symptoms to hospitalization was 7 days. In the elderly with a very severe form of the disease, respiratory dyspnea (P=0.002) and decreased level of consciousness (P<0.0001) were higher. The average hospital stay was 7 days. In very severe form it lasted up to 11 days. ICU mortality and hospitalization were higher in patients with very severe forms of the disease. With the increasing delay in the days of hospitalization, the severity of the disease and mortality has increased.
Conclusion: The study showed that prolonging the onset of symptoms till hospitalization worsens prognosis and also exacerbates the disease and increases mortality in the elderly.
Methods: The present retrospective cohort study was performed on 444 elderly patients with Covid-19 admitted from 1 April until late October 2020 in Baharloo Hospital in Tehran, Iran. After being diagnosed using the results of RT-PCR and CT scan, patients, were divided into 3 groups: moderate, severe and very severe based on the severity of the disease. Analysis of variance was used to compare quantitative data and a chi-square test was used to examine qualitative variables in disease groups.
Results: From 444 elderly participants in the study, 73% were infected moderately, 15% severely, and 12% had a very severe form. The mean age was 72.90±8.42 and patients with a very severe form of the disease (75.68±8.28) were older. The average time from the onset of symptoms to hospitalization was 7 days. In the elderly with a very severe form of the disease, respiratory dyspnea (P=0.002) and decreased level of consciousness (P<0.0001) were higher. The average hospital stay was 7 days. In very severe form it lasted up to 11 days. ICU mortality and hospitalization were higher in patients with very severe forms of the disease. With the increasing delay in the days of hospitalization, the severity of the disease and mortality has increased.
Conclusion: The study showed that prolonging the onset of symptoms till hospitalization worsens prognosis and also exacerbates the disease and increases mortality in the elderly.
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Ahmad Shalbaf , Nasrin Amini, Hadi Choubdar, Mahdi Mahdavi, Atefeh Abedini, Reza Lashgari,
Volume 79, Issue 12 (3-2022)
Volume 79, Issue 12 (3-2022)
Abstract
Background: Early prediction of the outcome situation of COVID-19 patients can decrease mortality risk by assuring efficient resource allocation and treatment planning. This study introduces a very accurate and fast system for the prediction of COVID-19 outcomes using demographic, vital signs, and laboratory blood test data.
Methods: In this analytic study, which is done from May 2020 to June 2021 in Tehran, 41 features of 244 COVID-19 patients were recorded on the first day of admission to the Masih Daneshvari Hospital. These features were categorized into eight different groups, demographic and patient history features, vital signs, and six different groups of laboratory blood tests including complete blood count (CBC), coagulation, kidney, liver, blood gas, and general. In this study, first, the significance of each of the extracted features and then the eight groups of features for prediction of mortality outcomes were considered, separately. Finally, the best combination of different groups of features was assessed. The statistical methods including the area under the receiver operating characteristic curve (AUC-ROC) based on binary Logistic Regression classification algorithm were used for evaluation.
Methods: In this analytic study, which is done from May 2020 to June 2021 in Tehran, 41 features of 244 COVID-19 patients were recorded on the first day of admission to the Masih Daneshvari Hospital. These features were categorized into eight different groups, demographic and patient history features, vital signs, and six different groups of laboratory blood tests including complete blood count (CBC), coagulation, kidney, liver, blood gas, and general. In this study, first, the significance of each of the extracted features and then the eight groups of features for prediction of mortality outcomes were considered, separately. Finally, the best combination of different groups of features was assessed. The statistical methods including the area under the receiver operating characteristic curve (AUC-ROC) based on binary Logistic Regression classification algorithm were used for evaluation.
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Results: The results revealed that red cell distribution width (RDW), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and mean corpuscular volume (MCV) in CBC features have the highest AUC with values of 85.29, 80.96, 79.94 and 79.70, respectively. Then, blood oxygen saturation level (SPO2) in vital features has a higher AUC with a value of 79.28. Moreover, combinations of features in the CBC group have the highest AUC with a value of 95.57. Then, coagulation and vital signs groups have the highest AUC with values of 85.20 and 83.84, respectively. Finally, triple combinations of features in CBC, vital signs, and coagulation groups have the highest AUC with the value of 96.54.
Conclusion: Our proposed system can be used as an assistant acceptable tool for triage of COVID-19 patients to determine which patient will have a higher risk for hospitalization and intensive care in medical environments. |
Hamidreza Shetabi, Mehrdad Norouzi , Hossein Mahjubipour, Anahita Naviafar,
Volume 80, Issue 6 (9-2022)
Volume 80, Issue 6 (9-2022)
Abstract
Background: Coronavirus in 2019 was recognized as one of the leading causes of death worldwide. According to reports, the mortality rate in people who need mechanical ventilation varies from 50 to 97 percent. The aim of this study was to evaluate the outcome of Covid-19 disease based on different characteristics in patients and mechanically ventilated variables.
Methods: This descriptive-analytical study was conducted on 160 patients with a definite diagnosis of Covid-19 who were under mechanical ventilation and admitted to the intensive care unit of Alzahra Hospital in Isfahan from March 2020 to March 2021. Data was collected by checklist. The checklist included demographic information, including age, gender, as well as information such as underlying diseases, disease outcome, length of hospitalization, etc. After collecting the data, they were analyzed in SPSS software version 22 and at a significance level of less than 0.05.
Methods: This descriptive-analytical study was conducted on 160 patients with a definite diagnosis of Covid-19 who were under mechanical ventilation and admitted to the intensive care unit of Alzahra Hospital in Isfahan from March 2020 to March 2021. Data was collected by checklist. The checklist included demographic information, including age, gender, as well as information such as underlying diseases, disease outcome, length of hospitalization, etc. After collecting the data, they were analyzed in SPSS software version 22 and at a significance level of less than 0.05.
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Results: In this study, the overall mortality rate among mechanically ventilated patients was 62.5%. The mean age of patients was 69.99±17.87 years and the mean duration of hospitalization in surviving patients was 15.47±11.73 days and for deceased ones was 55.21±69.14 days. The mean age of the deceased group (65.71±16.59) was significantly higher than the surviving group 53±21.17 was (P=0.0001). The length of hospital stay in the deceased group was significantly longer than the surviving group (P=0.005). As a result, ventilator mode and inotropic agent intake during treatment increased the chance of mortality in patients under mechanical ventilation (P=0.001). There was a significant relationship between underlying diseases of hypertension, kidney disease and autoimmune disease with mortality in patients (P<0.05).
Conclusion: Various factors including the length of stay in the hospital, comorbidities such as hypertension, renal disease and autoimmunity may affect the outcome of critically ill ICU patients under mechanical ventilation. Patients who require long-term invasive ventilation and the use of inotropic drugs to maintain their cardiovascular status while hospitalized in the ICU are at higher risk for mortality. |
Farhad Soltani, Foroogh Doraghi, Saeed Hesam, Fereshteh Amiri ,
Volume 80, Issue 11 (2-2023)
Volume 80, Issue 11 (2-2023)
Abstract
Background: One of the major challenges in intensive care unit (ICU) patients is sepsis. The incidence of sepsis in patients admitted to the ICU has been reported from 13.6-39.3%. Many factors affect patient mortality, including acute phase proteins such as albumin.
Methods: The present study was a retrospective study in which patients with a diagnosis of sepsis referred to Golestan Hospital in Ahvaz from March to August were collected. In the present study, patients with sepsis admitted to the ICU who did not show improvement for more than 7 days were evaluated for length of hospital stay, survival and the relationship with albumin levels. During the study, albumin was checked every 72 hours and its validation was done. Based on albumin levels less than 2.6, they were treated with albumin. The patients who did not have an increase in the level of albumin remained in the study.
Methods: The present study was a retrospective study in which patients with a diagnosis of sepsis referred to Golestan Hospital in Ahvaz from March to August were collected. In the present study, patients with sepsis admitted to the ICU who did not show improvement for more than 7 days were evaluated for length of hospital stay, survival and the relationship with albumin levels. During the study, albumin was checked every 72 hours and its validation was done. Based on albumin levels less than 2.6, they were treated with albumin. The patients who did not have an increase in the level of albumin remained in the study.
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Results: 124 patients including 64 women (51.6) and 60 men (48.4) with a mean age of 66.4±15.4 were included in the study. The mean duration of hospitalization was 31.4±18.9 days, in which 24 patients (19.4%) died and 100 patients (80.6%) were discharged. Age, albumin and protein levels were associated with disease prognosis (P<0.001). Also, the duration of hospitalization in the deceased patients was longer than the recovered patients (27.7±25 vs. 32±17.1) (P=0.04). After further investigations, it was found that there is no difference between the deceased people (66±15.7) and the recovered people (67.7±14.1) (P=0.7).
Conclusion: The results of the present study showed that albumin has a direct effect on the severity of sepsis and this issue affects older patients more. Therefore, it is recommended that albumin be considered as a risk factor and one of the influential factors in choosing the best treatment strategy, which is associated with a reduction in mortality, hospitalization and treatment costs. |
Tayebeh Lakzaei, Niloofar Khoshnam-Rad , Maryam Edalatifard , Hamidreza Abtahi,
Volume 81, Issue 3 (6-2023)
Volume 81, Issue 3 (6-2023)
Abstract
Background: Despite the progress of medical science and organ transplantation, lung transplantation is associated with significant complications and mortality. In Iran, the first lung transplant was performed in 2000 at Imam Khomeini Hospital in Tehran. So far, there has been no assessment of the patients. The main purpose of this study is to investigate the status of lung transplantation status at this center.
Methods: In this retrospective longitudinal study, all lung transplant patients referred to the Lung Transplantation Center of Imam Khomeini Hospital in Tehran from April 2000 to March 2022 were examined. Demographic and clinical data, and information related to their current status, including pulmonary function tests, transplant-related complications, pharmacotherapy, and drug-related adverse events were recorded. Appropriate statistical analysis was applied.
| Results: During the study, 20 lung transplants were observed, 20 percent of transplant recipients were women, and 80 percent were men. The mean age of the patients at the time of transplantation was 39.3±11.4 years. The youngest patient at the time of transplantation was 22, and the oldest was 60 years old. The most common indication for transplantation was interstitial lung disease (70%) followed by chronic obstructive respiratory disease. The average forced expiratory volume in one second (FEV1) value of the patients in the first year was about 50%, which gradually decreased to less than 20 percent in the fifth year. The average survival after transplantation was 5.75±4.6 years. The post-transplant one month, three months, one year, three years, and five years survival were 80, 75, 70, 60, and 50 percent, respectively. Chronic lung allograft dysfunction and serious infections are the most common causes of mortality. Conclusion: The transplant center at Imam Khomeini Hospital is one of the most important lung transplant centers in Iran. The survival status and transplant outcome are comparable with those reported around the world. More attention should be paid to infection control, patient selection, and perioperative care to improve the outcomes of lung transplantation. |
Samaneh Eslami, Iman Mousaei, Masoumeh Andish, Ensieh Tavana , Amin Moradi, Ali Taghipour, Ehsan Mosa Farkhani ,
Volume 81, Issue 6 (9-2023)
Volume 81, Issue 6 (9-2023)
Abstract
Background: Alkaptonuria is a rare disorder that leads to excessive production and accumulation of homogentisic acid in body tissues, and this increase causes tissue degeneration and organ dysfunction through a process called achromasia. Due to very few studies in the field of this disease and access to epidemiological data for the first time in Iran, the present study was conducted with the aim of epidemiological investigation of the mortality rate of patients with alkaptonuria during the years 2013 to 2022 in Iran.
Methods: The design of the present study was cross-sectional (descriptive-analytical). The data related to the deceased registered according to the international coding system of diseases (ICD-10) were extracted from the system of registration and classification of the causes of death of Iran for death due to alkaptonuria disease. The variables investigated in this study included: age, gender and residence status of the deceased. Chi-square and Fisher's exact test were also used to analyze the data.
Methods: The design of the present study was cross-sectional (descriptive-analytical). The data related to the deceased registered according to the international coding system of diseases (ICD-10) were extracted from the system of registration and classification of the causes of death of Iran for death due to alkaptonuria disease. The variables investigated in this study included: age, gender and residence status of the deceased. Chi-square and Fisher's exact test were also used to analyze the data.
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Results: The specific death rate was calculated as 0.31 per one million people of the population. In this study, 90% of the deaths occurred at the age of less than five years. The age variable included two groups of less than five years and more than five years, where 90% of deaths occurred at the age of less than five years. 60% of the deceased were men and 40% were women. Regarding the residence status variable, 82% of the cases were urban and the rest were rural. Finally, there was no significant difference between the incidence of death due to alkaptonuria disease and the investigated variables, which are age (P=0.291), gender (P=0.958) and residence status (P=0.273).
Conclusion: According to the findings in the present study, although no significant difference was observed between age and the number of cases of death due to alkaptonuria; But most cases of death have occurred in young age groups, which seems that more studies are needed to understand the different dimensions of this disease |
Firooz Balavandi, Hossein Moradkhani,
Volume 82, Issue 10 (1-2025)
Volume 82, Issue 10 (1-2025)
Abstract
Background: Chronic heart failure (CHF) is a leading cause of cardiovascular mortality and hospitalization. Heart failure (HF) imposes both direct costs to healthcare systems and indirect costs to society through complications, unpaid care costs, premature mortality, and loss of productivity. The aim of the present study was to investigate the quality of care, laboratory and clinical indicators affecting mortality in heart failure patients.
Methods: In a descriptive study conducted in the summer of 1402, data were collected by extracting the list of patients who died with a diagnosis of heart failure from the hospital's information management system, based on random sampling, and recorded in a checklist. The number of patients selected was from a study of factors affecting mortality in heart failure patients at Shahid Mustafa Khomeini Hospital.
Results: 25.8% of patients had bilateral rales on pulmonary auscultation, and 88.7% of them reported shortness of breath, 58.1% edema, and 22.6% chest pain. LVEF of most patients was 10-25. With a decrease in systolic blood pressure and an increase in diastolic and HR, the probability of mortality increased significantly (1.058, 0.932, and 0.983) times, respectively. With a decrease in oxygen level, the probability of mortality increased significantly by 0.983 times. The mean ALT and AST increased significantly and the mean HCT also decreased significantly. With each unit increase in ALT and AST and each unit decrease in Hct, the probability of mortality increased (1.008, 0.985 and 1.283) times, respectively. With the decrease in Hb and FBS and the increase in Cr and BUN, the probability of mortality increased by 0.314, 1.013, 1.884 and 0.969 times, respectively. However, no significant relationship was observed between mortality and the factors Hb, FBS, Cr and BUN with patient mortality.
Conclusion: Dyspnea and edema were common in patients, and bilateral rales and chest pain were observed in less than half of the patients. A decrease in systolic blood pressure and an increase in diastolic and HR significantly increased the probability of mortality. A decrease in oxygen levels also significantly increased mortality in patients.
Methods: In a descriptive study conducted in the summer of 1402, data were collected by extracting the list of patients who died with a diagnosis of heart failure from the hospital's information management system, based on random sampling, and recorded in a checklist. The number of patients selected was from a study of factors affecting mortality in heart failure patients at Shahid Mustafa Khomeini Hospital.
Results: 25.8% of patients had bilateral rales on pulmonary auscultation, and 88.7% of them reported shortness of breath, 58.1% edema, and 22.6% chest pain. LVEF of most patients was 10-25. With a decrease in systolic blood pressure and an increase in diastolic and HR, the probability of mortality increased significantly (1.058, 0.932, and 0.983) times, respectively. With a decrease in oxygen level, the probability of mortality increased significantly by 0.983 times. The mean ALT and AST increased significantly and the mean HCT also decreased significantly. With each unit increase in ALT and AST and each unit decrease in Hct, the probability of mortality increased (1.008, 0.985 and 1.283) times, respectively. With the decrease in Hb and FBS and the increase in Cr and BUN, the probability of mortality increased by 0.314, 1.013, 1.884 and 0.969 times, respectively. However, no significant relationship was observed between mortality and the factors Hb, FBS, Cr and BUN with patient mortality.
Conclusion: Dyspnea and edema were common in patients, and bilateral rales and chest pain were observed in less than half of the patients. A decrease in systolic blood pressure and an increase in diastolic and HR significantly increased the probability of mortality. A decrease in oxygen levels also significantly increased mortality in patients.
Neda Faraji, Mahbobeh Alizadeh, Asghar Ghorbani, Hadiseh Hosami Roodsari , Samane Akbarpour , Mohammad Arefi,
Volume 82, Issue 11 (2-2025)
Volume 82, Issue 11 (2-2025)
Abstract
Background: This study aimed to evaluate serum amylase levels in hospitalized COVID-19 patients and investigate its association with disease prognosis. Elevated serum amylase levels have been reported in some COVID-19 patients, particularly in severe cases. This increase may indicate pancreatic involvement (pancreatitis) due to viral infection. This cross-sectional study aimed to evaluate the role of serum amylase levels as a prognostic marker in COVID-19 patients.
Methods: This descriptive cross-sectional study was conducted on 150 hospitalized patients with confirmed COVID-19 at Baharloo Hospital, Tehran, over a one-year period (July 2021–July 2022). The results showed that 20% of patients (30 out of 150) had elevated serum amylase levels. Patients with high amylase levels had significantly longer hospital stays (mean 14 days vs. 8 days) and higher mortality rates (15% vs. 5%). Additionally, these patients were more likely to require intensive care (25% vs. 10%). Statistical analysis revealed that elevated serum amylase levels were independently associated with poorer clinical outcomes.
Results: These results have important clinical implications for patient management. Routine measurement of serum amylase at admission could help identify high-risk patients who may benefit from closer monitoring and early intervention. Further research is needed to determine whether specific treatments for pancreatic involvement could improve outcomes in these patients.
Conclusion: These findings suggest that measuring serum amylase levels at admission can serve as a simple and accessible marker for identifying high-risk patients. Elevated amylase in COVID-19 patients is an important biological indicator of multi-organ involvement (pancreas and kidney) and severe inflammation, which is associated with worse prognosis and higher mortality. Monitoring this marker may aid clinical decision-making and improve patient outcomes
Methods: This descriptive cross-sectional study was conducted on 150 hospitalized patients with confirmed COVID-19 at Baharloo Hospital, Tehran, over a one-year period (July 2021–July 2022). The results showed that 20% of patients (30 out of 150) had elevated serum amylase levels. Patients with high amylase levels had significantly longer hospital stays (mean 14 days vs. 8 days) and higher mortality rates (15% vs. 5%). Additionally, these patients were more likely to require intensive care (25% vs. 10%). Statistical analysis revealed that elevated serum amylase levels were independently associated with poorer clinical outcomes.
Results: These results have important clinical implications for patient management. Routine measurement of serum amylase at admission could help identify high-risk patients who may benefit from closer monitoring and early intervention. Further research is needed to determine whether specific treatments for pancreatic involvement could improve outcomes in these patients.
Conclusion: These findings suggest that measuring serum amylase levels at admission can serve as a simple and accessible marker for identifying high-risk patients. Elevated amylase in COVID-19 patients is an important biological indicator of multi-organ involvement (pancreas and kidney) and severe inflammation, which is associated with worse prognosis and higher mortality. Monitoring this marker may aid clinical decision-making and improve patient outcomes
Reza Baghbanian, Shirin Azizidoost , Kamran Mahmoodi , Mahbobeh Rashidi , Golshan Mirmomeni, Sina Ganji Nataj ,
Volume 82, Issue 12 (3-2025)
Volume 82, Issue 12 (3-2025)
Abstract
Background: Coagulopathy is one of the most common causes of mortality in the intensive care unit. This study was designed and implemented to investigate the relationship between acidosis and coagulation disorders in patients undergoing laparotomy in the intensive care unit.
Methods: This retrospective study reviewed the files of 121 patients undergoing laparotomy in the intensive care unit of Imam Khomeini Hospital of Ahvaz during 2024. Demographic and clinical records and blood test results were extracted to measure parameters related to acidosis and coagulation tests. Then, the rates of coagulopathy, thrombocytopenia, acidosis, and patient outcome were calculated. The data obtained were analyzed using SPSS version 27 software.
Results: Most patients studied were male (72 (59.5%)) with a mean age of 54.18±21.1 years and a mean length of stay of 6.78±5.87 days. Hypertension (34 (28.1%)) was the most important comorbidity and peritonitis (54 (44.6%)) was the most important cause of hospitalization. The incidence rates of coagulopathy, thrombocytopenia, and acidosis were reported to be 29 (24%), 27 (22.3%) and 115 (95%), respectively. A total of 44 (36.5%) patients died during the study period. Although the rates of coagulopathy and thrombocytopenia were higher in patients with acidosis, these differences were not significant (P<0.05). The mortality rates among those without thrombocytopenia, mild, moderate, and severe thrombocytopenia were reported as 27 (28.7%), 4 (33.3%), 9 (81.1%), and 4 (100%), respectively, showing a significant difference (P=0.001). The mean pH in deceased patients was significantly lower than in others (0.13±7.19 vs. 0.88±7.25; P=0.005). The mortality rate in patients with coagulopathy was also significantly higher than in others (20 (69%) vs.24 (26.4%); P=0.000).
Conclusion: The incidence of acidosis and coagulation disorders in patients undergoing laparotomy and admitted to the intensive care unit is significant and is linked to poorer outcomes for these patients. However, acidosis was not found to be an independent risk factor for coagulation disorders in this population. Further research is necessary to confirm or refute these findings.
Methods: This retrospective study reviewed the files of 121 patients undergoing laparotomy in the intensive care unit of Imam Khomeini Hospital of Ahvaz during 2024. Demographic and clinical records and blood test results were extracted to measure parameters related to acidosis and coagulation tests. Then, the rates of coagulopathy, thrombocytopenia, acidosis, and patient outcome were calculated. The data obtained were analyzed using SPSS version 27 software.
Results: Most patients studied were male (72 (59.5%)) with a mean age of 54.18±21.1 years and a mean length of stay of 6.78±5.87 days. Hypertension (34 (28.1%)) was the most important comorbidity and peritonitis (54 (44.6%)) was the most important cause of hospitalization. The incidence rates of coagulopathy, thrombocytopenia, and acidosis were reported to be 29 (24%), 27 (22.3%) and 115 (95%), respectively. A total of 44 (36.5%) patients died during the study period. Although the rates of coagulopathy and thrombocytopenia were higher in patients with acidosis, these differences were not significant (P<0.05). The mortality rates among those without thrombocytopenia, mild, moderate, and severe thrombocytopenia were reported as 27 (28.7%), 4 (33.3%), 9 (81.1%), and 4 (100%), respectively, showing a significant difference (P=0.001). The mean pH in deceased patients was significantly lower than in others (0.13±7.19 vs. 0.88±7.25; P=0.005). The mortality rate in patients with coagulopathy was also significantly higher than in others (20 (69%) vs.24 (26.4%); P=0.000).
Conclusion: The incidence of acidosis and coagulation disorders in patients undergoing laparotomy and admitted to the intensive care unit is significant and is linked to poorer outcomes for these patients. However, acidosis was not found to be an independent risk factor for coagulation disorders in this population. Further research is necessary to confirm or refute these findings.
Parviz Karimi, Hossein Seidkhani, Zahra Mohebinejad, Shayan Hasanvand,
Volume 83, Issue 4 (7-2025)
Volume 83, Issue 4 (7-2025)
Abstract
Background: Seizures are common neurological disorders in childhood, with a prevalence of 4 to 6 cases per 1,000 children in the community. This study was conducted to evaluate the prognosis of the first non-provoked seizure in terms of recurrence.
Methods: In this descriptive-analytical study, the records of all patients hospitalized with a diagnosis of seizure without a trigger for the first time at Imam Khomeini Hospital in Ilam from April 2016 to March 2019 were reviewed retrospectively. Information was extracted from the patients' records. All records were reviewed in terms of seizure type characteristics.
Results: The results of imaging with seizure recurrence in these patients showed that there was a significant relationship between the result of the first imaging and the report of seizure recurrence (P≥0.001 and Phi-Cramers=0.729). Since EEG of all patients was not recorded, they were excluded from the study. There was also a significant relationship between drug treatment and seizure recurrence at a significance level of 5% (P=0.004 and Phi-Cramers=0.273). This study showed that among the 64 patients who had started drug treatment, 44 reported no seizure recurrence and 20 reported seizure recurrence, and among the 54 patients who had not received drug treatment, 23 reported no seizure recurrence and 31 reported seizure recurrence. In the first year, the highest frequency of seizure recurrence was in the first 6 months. With increasing time after seizure, the rate of seizure recurrence decreased. The highest percentage of seizures without a triggering factor was in the age group of 5-10 years and the lowest percentage was in the age group under 5 years.
Conclusion: Identifying key factors associated with seizure recurrence will enable healthcare professionals to tailor their diagnostic and therapeutic approaches, ultimately enhancing patient care and safety. By understanding the importance of family history, seizure characteristics, and neuroimaging findings, clinicians can make informed decisions that may prevent life-threatening complications and minimize cognitive impairment in affected children.
Methods: In this descriptive-analytical study, the records of all patients hospitalized with a diagnosis of seizure without a trigger for the first time at Imam Khomeini Hospital in Ilam from April 2016 to March 2019 were reviewed retrospectively. Information was extracted from the patients' records. All records were reviewed in terms of seizure type characteristics.
Results: The results of imaging with seizure recurrence in these patients showed that there was a significant relationship between the result of the first imaging and the report of seizure recurrence (P≥0.001 and Phi-Cramers=0.729). Since EEG of all patients was not recorded, they were excluded from the study. There was also a significant relationship between drug treatment and seizure recurrence at a significance level of 5% (P=0.004 and Phi-Cramers=0.273). This study showed that among the 64 patients who had started drug treatment, 44 reported no seizure recurrence and 20 reported seizure recurrence, and among the 54 patients who had not received drug treatment, 23 reported no seizure recurrence and 31 reported seizure recurrence. In the first year, the highest frequency of seizure recurrence was in the first 6 months. With increasing time after seizure, the rate of seizure recurrence decreased. The highest percentage of seizures without a triggering factor was in the age group of 5-10 years and the lowest percentage was in the age group under 5 years.
Conclusion: Identifying key factors associated with seizure recurrence will enable healthcare professionals to tailor their diagnostic and therapeutic approaches, ultimately enhancing patient care and safety. By understanding the importance of family history, seizure characteristics, and neuroimaging findings, clinicians can make informed decisions that may prevent life-threatening complications and minimize cognitive impairment in affected children.
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