Swiss Med Wkly Research Articles

Management of transthyretin amyloidosis.

Transthyretin amyloidosis (ATTR amyloidosis) is a disease caused by deposition of transthyretin fibrils in organs and tissues, which causes their dysfunction. The clinical heterogeneity of ATTR amyloidosis and the variable presentation of symptoms at early disease stages, historically meant treatment delays. Diagnostic tools and therapy options of ATTR amyloidosis have markedly improved in recent years. The first Swiss Amyloidosis Network (SAN) meeting (Zurich, Switzerland, January 2020) aimed to define a consensus statement regarding the diagnostic work-up and treatment for systemic amyloidosis, tailored to the Swiss healthcare system. A consortium of 45 clinicians and researchers from all Swiss regions and universities was selected by the SAN committee to represent all sub-specialty groups involved in care of patients with amyloidosis. A steering committee conducted the literature search and analysis, wrote the critical synthesis and elaborated a list of statements that were evaluated by all the participants. These recommendations will improve outcomes and quality of life for patients with ATTR amyloidosis. A global review of these guidelines is planned every 3 years with a formal meeting of all the involved experts.

Brain Injury in Critical Illness and a Note on the Virus

Brain Injury in Critical Illness and a Note on the Virus

Classification of Individuals Based on Autonomic Response to Virtual Gaming

Modern games consists of digital gaming consoles that involves interaction with a user and has an interface to generate visual feedback through 2D/3D monitor. These games have several psychological side effects like loss of spatial awareness, back pains, insomnia, addiction, aggression, stress, and hypertension. Virtual reality (VR) Gaming is one of the most emerging and novel technologies in the field of entertainment. Evaluation of this new technology has become important in order to analyze the effects of its predecessors (2D and 3D gaming). The main focus of this paper is on detection of stress levels in individuals due to VR gaming and classify them depending on their sympathetic and parasympathetic dominance. This is done through acquisition of electrocardiogram (ECG) and photo plethysmograph signals (PPG) signals and extracting their time domain and frequency domain features before, during and after gaming (Fatma Uysal and Mahmut Tokmakçi, 2018. Evaluation of stress parameters based on heart rate variability measurement. Department of Biomedical Engineering, Erciyes University, Kayseri, Turkey. fatmauysal@erciyes.edu.tr, tokmakci@erciyes.edu.tr., da Silva1, A.G.C.B., Arauj, D.N., et al, 2018. Increase in perceived stress is correlated to lower heart rate variability in healthy young subjects. Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. s/n., 81531–980, Curitiba, Parana, Brazil. E-mail: fernandoaldias@gmail.com.). The physiological signal variation is analyzed by performing Heart Rate Variability (HRV) analysis over ECG signals which is one of the fast emerging methods in non-invasive research and clinical tools for assessing autonomic nervous system function (Juan Sztajzel, 2004. Heart rate variability: Aa non-invasive electrocardiographic method to measure the autonomic nervous system. Cardiology Center and Medical Policlinics, University Hospital, Geneva, Switzerland, SWISS MED WKLY 2004;134:514–522. www.smw.ch). Pulse-transmissiontime-variability (PTTV), which is extracted, has high coherence with heart rate variability and is also used as an objective measure of stress. In this paper we obtain the response of an individual during VR gaming and correlate them with the HRV/PTT parameters. The game chosen for the data acquisition was ‘VR city view rope crossing-360 android VR,’ during which data recording is done. It was found that there was a quantitative increase in physiological stress when individuals were exposed to virtual high heights in comparison with time relative to unaltered viewing. Mean Heart rate showed a significant increase during gaming for both boys and girls which indicates that the body is under the influence of a sympathetic activity like a physical exercise.

The role of palliative care during the coronavirus (COVID-19) pandemic.

International Journal of Palliative NursingVol. 26, No. 5 CommentThe role of palliative care during the coronavirus (COVID-19) pandemicAbdolrahim Hazini, Saeed Mohammadpour, Samira SoleimanpourAbdolrahim HaziniOncologist and Director of the Department of Oncology and Palliative Care, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IranSearch for more papers by this author, Saeed MohammadpourPhD candidate in Health Economics, Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IranSearch for more papers by this author, Samira SoleimanpourCorrespondence to: E-mail Address: [email protected]PhD Candidate, Department of Librarianship and Medical Information, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IranSearch for more papers by this authorAbdolrahim Hazini; Saeed Mohammadpour; Samira SoleimanpourPublished Online:25 Jun 2020https://doi.org/10.12968/ijpn.2020.26.5.198AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Etkind S, Bone A, Gomes B, Lovell N, Evans C, Higginson I, Murtagh FEM. How many people will need palliative care in 2040? Past trends, future projections and implications for services. BMC Med. 2017; 15(1):102. https://doi.org/10.1186/s12916-017-0860-2 Crossref, Medline, Google ScholarKunz R, Minder M. COVID-19 pandemic: palliative care for elderly and frail patients at home and in residential and nursing homes. Swiss Med Wkly. 2020; 150:w20235. https://doi.org/10.4414/smw.2020.20235 Medline, Google ScholarSingh AG, Deodhar J, Chaturvedi P. Navigating the impact of COVID-19 on palliative care for head and neck cancer. Head Neck. 2020; 42(6):1144–1146. https://doi.org/10.1002/hed.26211 Crossref, Medline, Google ScholarSpicer J, Chamberlain C, Papa S. Provision of cancer care during the COVID-19 pandemic. Nat Rev Clin Oncol. 2020; 17(6):329–331. https://doi.org/10.1038/s41571-020-0370-6 Crossref, Medline, Google ScholarWang SSY, Teo WZW, Teo WZY, Chai YW. Virtual reality as a bridge in palliative care during COVID-19. J Palliat Med. 2020; 23(6):756. https://doi.org/10.1089/jpm.2020.0212 Crossref, Medline, Google ScholarWorld Health Organization. WHO definition of palliative care. 2020. www.who.int/cancer/palliative/definition/en/ (accessed 10 June 2020) Google Scholar FiguresReferencesRelatedDetails 2 June 2020Volume 26Issue 5ISSN (print): 1357-6321ISSN (online): 2052-286X Metrics History Published online 25 June 2020 Published in print 2 June 2020 Information© MA Healthcare LimitedPDF download

Comment on: Mumme M, et al. Tissue engineering for paediatric patients. Swiss Med Wkly. 2019.149.w20032.

Comment on: Mumme M, et al. Tissue engineering for paediatric patients. Swiss Med Wkly. 2019.149.w20032.

Reply to comment on: Mumme M, et al. Tissue engineering for paediatric patients. Swiss Med Wkly. 2019.149.w20032.

Reply to comment on: Mumme M, et al. Tissue engineering for paediatric patients. Swiss Med Wkly. 2019.149.w20032.

MON-904 Behind the Mask: The Stories of Insulinoma- a Case Series

Introduction: Insulinoma is a rare, slow growing pancreatic neuroendocrine tumor, leading to hyperinsulinemic hypoglycemia. It runs a very insidious course often masquerading as neurologic, psychological or cardiac disease. We present a series of four cases with varying clinical presentations, diagnoses and latency to diagnosis.Case Report: This is a retrospective analysis of four cases of Insulinoma diagnosed between Sep 2016 and Mar 2019. All the patients were males and aged 36, 22, 63 and 15 years respectively. Baseline characteristics, duration to diagnosis of Insulinoma, diagnosis and treatment given before definitive diagnosis and post-surgery outcomes were analyzed. All the four patients had relatively long latency to diagnosis despite frequent, spontaneous hypoglycemic episodes, longest being ten years. The patients had a neurological and/or psychiatric diagnosis prior to definitive diagnosis. The symptoms improved with consumption of food. One of the four patients was on antipsychotics for episodic abnormal behavior before the diagnosis of Insulinoma. Two of them were on anti-epileptic medications for seizures. All the insulinomas were localized with CECT without requirement for additional localization techniques. All our patients responded well to surgical resection of the tumor. All insulinomas were benign grade 1 tumors. Acanthosis nigricans regressed in all the patients post-surgery. In addition, all the patients had significant weight loss post-surgery. Two of the four patients developed diabetes mellitus and were on insulin therapy.Conclusion: A strong index of suspicion of Insulinoma is warranted while dealing with patients presenting with seizure disorders, behavioral abnormalities and neurological symptoms because the spectrum of symptoms is wide and non-specific. Seeking diagnosis is of utmost importance because of implications on treatment and prognosis.Reference:Valente LG, Antwi K, Nicolas GP, Wild D, Christ E. Clinical presentation of 54 patients with endogenous hyperinsulinaemic hypoglycaemia: a neurological chameleon (observational study). Swiss Med Wkly. 2018 Nov 18;148:w14682.

Comment on: Wiser et al. Ovarian cancer in Switzerland: incidence and treatment according to hospital registry data. Swiss Med Wkly.2018;148:w14647

Wieser and colleagues, in a study published in Swiss Medical Weekly in July 2018, compared incidence rates of ovarian cancer derived from the cantonal cancer registries (CCRs) as published by the National Institute for Cancer Epidemiology and Registration (NICER) with those derived from the hospital discharge data compiled by the Swiss Federal Statistical Office. The authors observed a substantial difference between these two estimates. The average age-adjusted ovarian cancer incidence rate was 14.6 per 100,000 women per year over the period 2004–2012 compared with a rate of 11.3 per 100,000 women per year reported by NICER for the same period [1]. The authors argue that the figure provided by NICER is probably an underestimation of the true figure because cancer registry data are based on voluntary information on new cases from clinicians.With our response, we show that this conclusion is not correct and the observed high rate of ovarian cancer in hospital discharge data is an artefact, probably arising from incorrect coding of non-malignant ovarian tumours. Further, we explain the purpose of epidemiological cancer registries and their difference from routinely collected discharge data.

Reply to comment on: Wiser et al. Ovarian cancer in Switzerland: incidence and treatment according to hospital registry data. Swiss Med Wkly.2018;148:w14647.

Reply to comment on: Wiser et al. Ovarian cancer in Switzerland: incidence and treatment according to hospital registry data. Swiss Med Wkly.2018;148:w14647.

Comment on: Novosel D. Setting as informed consent in psychotherapy. Swiss Med Wkly.2019;149:w20028.

Comment on: Novosel D. Setting as informed consent in psychotherapy. Swiss Med Wkly.2019;149:w20028.

Reply to comment by Poppe C on: Novosel D. Setting as informed consent in psychotherapy. Swiss Med Wkly.2019;149:w20028.

Reply to comment by Poppe C on: Novosel D. Setting as informed consent in psychotherapy. Swiss Med Wkly.2019;149:w20028.

High Mobility Group Box 1 in experimental tuberculosis

High Mobility Group Box 1 in experimental tuberculosis

Differences In Treatment Patterns and Costs Among Diffuse Large B-Cell Lymphoma Patients Treated In The Clinic Vs. The Hospital Outpatient Setting

BackgroundDiffuse large B-cell lymphoma (DLBCL) is the most common subtype of Non-Hodgkin's Lymphoma (NHL) accounting for approximately 30% of newly diagnosed casesi. DLBCL is an aggressive form of NHL and without treatment, median survival estimates are <1 year.ii Rituximab in combination with CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) is recommended first-line therapy for DLBCL patients and has been shown to improve overall survival compared with CHOP alone (previous standard therapy).iii In addition, published evidence suggests that receipt of granulocyte-colony stimulating factor (G-CSF) may improve outcomes among patients who initiate CHOP-based therapy.ivIt is unclear whether differences in treatment and outcomes exist among cancer patients by site where care is delivered. This study examines differences in treatment patterns, health care resource use and costs among DLBCL patients receiving rituximab (R) or R+ chemotherapy in the office/clinic (OC) setting vs. the hospital outpatient (HOSP) setting. MethodsThis retrospective study used medical and pharmacy claims (1/2007 - 7/2012) from a national US commercial health plan to identify patients at least18 years old with ≥2claims for R. Patients were required to have evidence of DLBCL (≥1 claim with ICD-9-CM 200.78 or ≥2 claims with unique diagnosis codes from ICD-9-CM 200.70 to 200.77) and be enrolled in the health plan for ≥6 months before and after the index date (date of the first R claim). The follow-up period, that is, the episode of care (EOC), was the date of the first R infusion through 30 days after the last infusion prior to a gap in R administration of at least 7 months; those with less than 6 months of follow-up due to death were included. Patients with multiple cancers or receipt of R at both the OC and HOSP setting during the EOC were excluded. Differences in number of infusions, receipt G-CSF, healthcare utilization and per-patient per-month (PPPM) health care costs by cohort were examined. ResultsA total of 491 patients were identified, 65% OC (n=320) and 35% HOSP (n=171): by insurance type, 140 Medicare Advantage patients, 39% HOSP and 351 commercially insured patients, 33% HOSP. From 2007 to 2011/2012, the percentage of patients in HOSP increased from 32% to 43%.Descriptive results are shown in the Table. The cohorts had similar mean age, baseline Charlson comorbidity index scores and similar EOC lengths. However, compared to the OC cohort, the HOSP cohort had fewer infusions during the EOC and fewer infusions per month. In addition, fewer HOSP patients had evidence of combination therapy and receipt of any G-CSF during the EOC. HOSP patients also had significantly higher rates of emergency room visits, but not hospitalizations compared to OC patients. Total PPPM costs during the EOC as well as average costs of anti-cancer systemic therapy drugs plus administration costs incurred on days of rituximab infusions were significantly higher among the HOSP cohort compared to the OC cohort. ConclusionsIncreasing proportions of DLBCL patients receive infusions in the HOSP setting. HOSP patients had fewer infusions per month and incurred greater costs on the day of infusion compared to the OC cohort. There were fewer patients in HOSP with evidence of G-CSF during the EOC compared to OC patients. Overall, total PPPM costs were higher among the HOSP cohort compared to the OC cohort. Future research is warranted to assess the impact of these differences on clinical outcomes by site of care.[i] Armitage et al. JCO 1998;16(8):2780-95[ii] Mey et al. Swiss Med Wkly 2012;140:w13511[iii] NCCN Guidelines Version 1.2013 Diffuse Large B-cell Lymphoma[iv] Donnelly, et al, Leuk Lymphoma. 2000;39(1-2):67-75 Disclosures:Reyes:Genentech, inc: Employment, Equity Ownership. Dacosta Byfield:Genentech, Inc: Genentech contracted with OptumInsight to conducting the work described in the abstract. Stacey is employed at Optum but did not receive funds directly from Genentech and employment is not contingent on work with Genentech., Genentech contracted with OptumInsight to conducting the work described in the abstract. Stacey is employed at Optum but did not receive funds directly from Genentech and employment is not contingent on work with Genentech. Other; OptumInsight: Employment. Becker:Genentech, Inc: Genentech contracted with OptumInsight to conducting the work described in the abstract. Laura is employed at Optum but did not receive funds directly from Genentech and employment is not contingent on work with Genentech., Genentech contracted with OptumInsight to conducting the work described in the abstract. Laura is employed at Optum but did not receive funds directly from Genentech and employment is not contingent on work with Genentech. Other; OptumInsight: Employment. Small:Genentech, Inc: Employment, Equity Ownership.

Update: Advances in Pediatric Cardiac Intensive Care

Update: Advances in Pediatric Cardiac Intensive Care

AB0743 Efficacy of anti-interleukin-6 receptor antibody (tocilizumab) in colombian patients with takayasu’s arteritis

BackgroundTakayasu’s arteritis (TA) is a chronic vasculitis that involves aorta and its main branches, where interleukin-6 (IL-6) seems to play a pathogenic role (1,2). The effect in four patients treated...

FRI0352 Treatment of refractory takayasu arteritis with tocilizumab: seven italian patients from a single referral center.

BackgroundTakayasu arteritis (TA) is an inflammatory large-vessel panarteritis resulting in vessel stenosis, occlusion or aneurysm formation1. Medical therapy with steroids and immunosuppressive agents is the cornerstone of TA although a...

Reply to Letter to the Editor: The proper blood pressure may impaire cardiovascular risk factors

We are very delighted about the international interest in ourpaper “Uncontrolled arterial hypertension in primary care –patient characteristics and associated factors” (Swiss MedWkly. 2012;142:w13693). We are especially delighted thatour work obviously is not only recognised by primary carephysicians, but also by specialists as the letter to the editorby Sait Demirkol [1] reflects.We are also thankful for the comment regarding the crosssectional design of our study. We agree with Demirkol andcolleagues that a cross sectional design can only show cor-relations but not prove any causality. This would only bepossible – as suggested by Demirkol et al. – by a followup. The data presented in our paper are derived from thebaseline-assessment of the CoCo trial, a randomised, con-trolled trial aiming at improving blood pressure control byusing a colour coded booklet for patients to note their bloodpressure measurements (Trials. 14 April 2010;11:38).It is our aim to follow the patients included in CoCo forat least one year. Therefore, we will be able – controlledfor the intervention – to analyse the influence of the de-tected risk factors for elevated blood pressure, namely age,smoking and a high body mass index over time. We arelooking forward to present these data soon.We agree with Demirkol and colleagues that patients withestablished cardiovascular diseases have a dysregulation ofvascular tone thus further promoting atherosclerosis. Asa consequence, blood pressure control by pharmacologic-al agents might differ depending on pleiotropic effects ofthese agents beyond blood pressure lowering, includinganti-oxidative and anti-inflammatory actions (Curr VascPharmacol. 2011 Mar;9(2):145–52, Clin Exp Hypertens.2012 Nov 30. [Epub ahead of print]). To investigate theeffect of various pharmacological agents was beyond thescope of the current study and unfortunately as stated inthe strengths and limitations section of our paper, co-mor-bidities were not systematically assessed. Therefore we arenot able to stratify for the factors: coronary artery disease,hypercholesterolemia or diabetes mellitus. Nevertheless,there is sufficient evidence that successful modification oflifestyle risk factors have a beneficial effect on blood pres-sure control irrespective of cardiovascular co-morbidities.Our cross-sectional results confirmed that the prevalence ofmodifiable cardiovascular risk factors is high in unselectedpatients with uncontrolled blood pressure thus demonstrat-ing the potential of successful lifestyle change programmesas mentioned by Demirkol and colleagues (Oman Med J.2012;27(6):511).

Familiarity, objectivity – and misconduct: Counterstatement to Shaw DM. The Swiss Report on homoeopathy: a case study of research misconduct. Swiss Med Wkly. 2012;142:w13594

Familiarity, objectivity – and misconduct: Counterstatement to Shaw DM. The Swiss Report on homoeopathy: a case study of research misconduct. Swiss Med Wkly. 2012;142:w13594

Neutrophil Gelatinase-Associated Lipocalin in chronic heart failure

Event Abstract Back to Event Neutrophil Gelatinase-Associated Lipocalin in chronic heart failure Nilgun Isiksacan1*, Murat Koser1, Mehmet Erturk2, Ibrahim Faruk Akturk2, Serkan Yazan2, Mehmet Rifat Yildirim2, Vesile Ornek Diker1 and Ihsan Bakir3 1 Istanbul Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, Central Laboratory, Turkey 2 Istanbul Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, Cardiology, Turkey 3 Istanbul Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, Cardiovascular Surgery, Turkey Introduction Chronic heart failure (CHF) is a progressive and complicated clinical syndrome, it is mostly accompanied by chronic renal disease. Glomerular filtration rate (GFR) is decreased in 30 to 50 % of patients with CHF. NGAL, neutrophil gelatinase-associated lipocalin, which is expressed mainly from neutrophils as a response to bacterial infections in innate immunity, is a new marker for renal function. The aim of this study is to evaluate the renal functions of the patients with CHF and determining the clinic importance of NGAL parameter as a biomarker in CHF. Material and Method Hundred patients (mean age: 67 ± 12 years) from cardiology outpatient clinic diagnosed as CHF enrolled to this study. Creatinine, CRP, BUN and NGAL levels were measured from venous blood samples in 2 hours after collection. According to CRP results, a possible bacterial infection is excluded. All the cases received written inform on the study including Ethics Committee Approval before the study was initiated. Spearman Correlation Analysis is performed. Results Patients with high CRP levels were excluded and NGAL levels did not correlate with normal CRP results(r=0.093, p=0.364). A weak correlation but a statistically significance was observed between NGAL and BUN levels (r=0.293, p=0.03). Also a correlation and a highly statistically significance was found between NGAL and creatinine (r=0.520, p<0.001). Conclusion In this study NGAL performance was found significantly better than BUN. A good correlation between NGAL and creatinine indicates that NGAL may be a candidate biomarker for renal functions in patients with CHF. References 1- Cystatin C and neutrophil gelatinase-associated lipocalin: biomarkers for acute kidney injury after congenital heart surgery. Seitza S, Rauh M, Gloeckler M, Cesnjevard R, Dittricha S, Kocha AME. Swiss Med Wkly. 2013;143:w13744. 2- Neutrophil Gelatinase-Associated Lipocalin (NGAL) predicts renal injury in acute decompensated cardiac failure: a prospective observational study. Macdonald S, Arendts G, Nagree Y, Xu XF. BMC Cardiovascular Disorders 2012, 12:8. Keywords: NGAL, CHF, Neutrophil, Renal functions, Creatinine Conference: 15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013. Presentation Type: Abstract Topic: Translational immunology and immune intervention Citation: Isiksacan N, Koser M, Erturk M, Akturk I, Yazan S, Yildirim M, Ornek Diker V and Bakir I (2013). Neutrophil Gelatinase-Associated Lipocalin in chronic heart failure. Front. Immunol. Conference Abstract: 15th International Congress of Immunology (ICI). doi: 10.3389/conf.fimmu.2013.02.00108 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 11 Mar 2013; Published Online: 22 Aug 2013. * Correspondence: Dr. Nilgun Isiksacan, Istanbul Mehmet Akif Ersoy Cardiovascular Training and Research Hospital, Central Laboratory, Istanbul, Turkey, nisiksacan@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Nilgun Isiksacan Murat Koser Mehmet Erturk Ibrahim Faruk Akturk Serkan Yazan Mehmet Rifat Yildirim Vesile Ornek Diker Ihsan Bakir Google Nilgun Isiksacan Murat Koser Mehmet Erturk Ibrahim Faruk Akturk Serkan Yazan Mehmet Rifat Yildirim Vesile Ornek Diker Ihsan Bakir Google Scholar Nilgun Isiksacan Murat Koser Mehmet Erturk Ibrahim Faruk Akturk Serkan Yazan Mehmet Rifat Yildirim Vesile Ornek Diker Ihsan Bakir PubMed Nilgun Isiksacan Murat Koser Mehmet Erturk Ibrahim Faruk Akturk Serkan Yazan Mehmet Rifat Yildirim Vesile Ornek Diker Ihsan Bakir Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Trauma profile at a tertiary intensive care unit in Saudi Arabia

BACKGROUND AND OBJECTIVESTrauma 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.DESIGN AND SETTINGA 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.PATIENTS AND METHODSWe 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.RESULTSDuring 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 the study period. Severe head injury, age > 60 years, Glascow coma scale score, injury severity scores, APACHE II and international normalized ratio were independent predictors of mortality.CONCLUSIONMVA is very common in our country and leads to significant mortality and morbidity. Public education and strict law enforcement are needed to reduce these adverse events.