Khan Nasim A, Ishag Adam M, Ahmad Maha S, El-Sayed Fifi M, Bachal Zakeyah A, Abbas Tahir G
Department of Medicine, Al-Noor Specialist Hospital, Makkah, Kingdom of Saudi Arabia.
Saudi Med J. 2006 Sep;27(9):1373-80.
To document the pattern of medical diseases necessitating admission in a tertiary care hospital during Muslim pilgrimage (Hajj). To assess the risk factors associated with mortality during hospitalization.
The study was conducted at Al Noor Specialist Hospital, a 550-bed tertiary care teaching hospital, in Makkah, KSA. The participants included all Hajj patients admitted in the Department of Medicine in a 5-week period (January 3 to February 6, 2005) during the 2005 (1425 AH) Hajj. Information about demographics; past medical history; pre-Hajj functional status; presence of language barrier and translator availability; diagnosis for admission and complications during hospitalization including mortality was obtained prospectively using a standardized form.
Six hundred and eighty-nine patients, belonging to 49 countries, with mean age of 62 years and male:female ratio of 1.8:1 were admitted. Two hundred-twenty (31.9%) had diabetes mellitus, 256 (37.2%) had hypertension, 219 (31.8%) had cardiac disease, and 103 (14.9%) patients had chronic lung disease. Of the 449 (65.2%) patients assessed, 284 (63.2%) patients had language barrier, and translator was not available for 152 (53.5%) of them. Pre-Hajj functional status assessment of 240 patients showed that 20 (8.3%) required assistance in performing activities of daily living (ADL), and 40 (16.7%) could not walk for half kilometer without difficulty. Common causes of morbidity were: 235 (34.1%) cardiovascular, 137 (19.9%) infectious and 85 (12.3%) neurological diseases. One hundered and fourteen (16.5%) patients died, with the common causes being pneumonia (28 patients), acute coronary syndrome (21), and stroke (20). The risk factors associated with higher mortality were older age (65 +/- 1 versus 61 +/- 0.6 years, p=0.008), prior history of chronic lung disease (crude odds ratio, 1.81, p=0.034), dependence in any ADLs (4.90, p=0.025), inability to ambulate for half kilometer without difficulty (4.17, p=0.017) and non-availability of translator for patients with language barrier (5.51, p<0.0001).
Most patients were elderly with high prevalence of chronic medical disorders. Non-infectious diseases accounted for most morbidity and mortality. Pre-Hajj functional assessment should be carried out to identify patients at high risk of mortality. Provision of translator services for patients with language barrier is essential to improve future outcomes.
记录在穆斯林朝圣（朝觐）期间需要入住三级护理医院的疾病模式。评估住院期间与死亡率相关的危险因素。
该研究在沙特阿拉伯麦加的努尔专科医院进行，这是一家拥有550张床位的三级护理教学医院。参与者包括在2005年（回历1425年）朝觐期间为期5周（2005年1月3日至2月6日）入住内科的所有朝觐患者。使用标准化表格前瞻性收集有关人口统计学、既往病史、朝觐前功能状态、语言障碍的存在及翻译人员可用性、入院诊断和住院期间并发症（包括死亡率）的信息。
共收治了来自49个国家的689名患者，平均年龄62岁，男女比例为1.8:1。220名（31.9%）患有糖尿病，256名（37.2%）患有高血压，219名（31.8%）患有心脏病，103名（14.9%）患有慢性肺病。在评估的449名（65.2%）患者中，284名（63.2%）有语言障碍，其中152名（53.5%）没有翻译人员。对240名患者的朝觐前功能状态评估显示，20名（8.3%）在日常生活活动（ADL）中需要协助，40名（16.7%）行走半公里有困难。发病的常见原因有：235例（34.1%）为心血管疾病，137例（19.9%）为感染性疾病，85例（12.3%）为神经系统疾病。114名（16.5%）患者死亡，常见原因是肺炎（28例）、急性冠状动脉综合征（21例）和中风（20例）。与较高死亡率相关的危险因素包括年龄较大（65±1岁对61±0.6岁，p=0.008）、既往慢性肺病病史（粗比值比，1.81，p=0.034）、任何ADL依赖（4.90，p=0.025）、行走半公里困难（4.17，p=0.017）以及有语言障碍的患者没有翻译人员（5.51，p<0.0001）。
大多数患者为老年人，慢性疾病患病率高。非感染性疾病占发病和死亡的大多数。应进行朝觐前功能评估以识别高死亡风险患者。为有语言障碍的患者提供翻译服务对于改善未来结局至关重要。
