Abuzer Coskun

Comparison of trauma scores for predicting mortality and morbidity on trauma patients.

BACKGROUND In this study, we compared the anatomical, and physiological scoring systems trauma revised injury severity score (TRISS), revised trauma score (RTS), injury severity score (ISS), new injury severity score (NISS) to each other, to find out the most accurate and reliable trauma score for the risk classification of morbidity and mortality among the trauma patients. METHODS This is a cross-sectional study, which included 633 patients who admitted to our University Hospital Emergency Department during an 8-month period due to trauma. All blunt and penetrating traumas (traffic accident, assault, etc.) patients above 16 years were included. RESULTS Arrival time trauma scores (ISS, NISS, RTS, and TRISS) of the patients was calculated. Mean trauma score for the mortality prediction was calculated, and the p value was equal for all (p=0.001). Trauma scores were also analyzed for the hospitalization time in intensive care unit (ICU). While NISS, RTS, and TRISS values were significant (p=0.048, p=0.048, and p=0.017, respectively), ISS value was not significant (p=0.257) for predicting the ICU hospitalization time. Only TRISS was a good predictor for the mechanically ventilation time in ICU patients (p=0.01). CONCLUSION In conclusion, we determined that the anatomical trauma scores (NISS, ISS) predicted the hospitalization and ICU necessities better, whereas TRISS, an anatomo-physiological trauma score, defined the ICU hospitalization and mechanically ventilation time better.

Bir Devlet hastanesi acil servisi demografik özellikleri: 2011 yılı meta analizi

Objective: The examination and treatment modalities should be measurable for improve the service quality of emergency service. This may be possible with the data collection system which is comprehensive and world-wide known. The aim of this study is to investigate the demographical features of patients who admitted to our service by computer based patient recording system and create a better service quality in the view of these data. Methods: Registered 115,185 patients were included whom admitted to our service between January 2011 and December 2011. The demographic characteristics, symptoms, triage distributions, the average length of stay, consultation rates, hospital admission forms, hospitalization and discharge rates were classified according to the Inter national Classification of Diseases-10 (ICD-10). Results: The mean age of patients was 38.70±19.92 years and 44.8% of the patients were male. Triage categories of the patients in category red, yellow and green 5.5%, 53.1%, 41.4%, respectively. Patients older than 65 years old were 14,643 (12.7%). Most common presentation day was Monday and the time period was between 20 p.m. and 24 p.m. The mean length of emergency service stay was 47 minutes, consultation and admission rates were 8.5% and 3.2%, respectively. 1,876 patients of older than 65 years old were admitted to the services. Conclusions: Emergency service admission registrations should be stored and analyzed by using the digital and sharable systems to serving a better qualified service in emergency services which provides continued service step to health care. This will allow the national standardization and determine the international location. J Clin Exp Invest 2013; 4 (3): 274-278

The Duration of Fasting in Ramadan Affects the Admissions to Emergency Department

Aim: One of the ways that Muslims worship in Ramadan is by fasting. People who are fasting may prefer to receive health services in the period between iftar and pre-dawn meal owing to the concern that their fasting may be interrupted with the medical interventions to be administered. For this reason, the workload of emergency departments that serve for continuous 24 h may increase in Ramadan. We have not encountered any study analyzing the comparison of emergency visits in the seasons when the period between iftar and pre-dawn is the shortest and longest. We aimed to compare the characteristics of visits to the adult emergency department between those in the year 2016 that included the longest fasting time and those in the year 2000 that included the shortest fasting time.

Bone marrow edema and pseudocyst as a very rare complication of familial mediterranean fever: a case report

Familial Mediterranean fever (FMF) is one of the most common autoinflammatory diseases. FMF is a disease that characterized by recurrent fever, transient and self-limiting polyserositis, responds well to the treatment of colchicine. In 95% of patients, the first attack occurs with severe abdominal pain. The first attack frequency that starts with pleuritic chest pain, pleural effusion and fever are lower than 10%. Ninety percent of the cases are younger than 20 years old. After 40 years old, it is rarely diagnosed (1.25%). In this case report; we wanted to present an FMF case diagnosed after 40 years old in the context of the patients clinical follow-up, treatment, and literature, since it is very rare to diagnose in this age group, and unexpected complications can occur.

Predicting of neuropsychosis in carbon monoxide poisoning according to the plasma troponin, COHb, RDW and MPV levels

OBJECTIVE Carbon monoxide (CO) poisoning is very common worldwide. In this study, we aimed to evaluate the predictivity of neuro psychosis in carbon monoxide poisoning by the admission levels of red cell distribution (RDW), mean platelet volume (MPV) and troponin I levels which can be measured quickly and easily in the emergency department (ED). PATIENTS AND METHODS This single center observational study included a total of 216 consecutive patients who presented to the ED due to CO poisoning between January 2009 and December 2013. The diagnosis of CO poisoning was made according to the medical history and carboxyhemoglobin (COHb) level of >5%. According to the carboxyhemoglobin levels, the patients were classified as mildly (COHb < 20%) and severely poisoned (COHb > 20%). In addition, patients were divided into 2 groups, i.e., those with positive (>0.05 ng/mL for our laboratory) and negative (<0.05 ng/mL for our laboratory) troponin levels. RESULTS Patients mean age was 52.58 ± 10.58. 57.9% of the patients had high troponin levels and 51.9% were poisoned severely according to COHb levels. Patients with positive troponin and COHb had longer CO exposure time and higher neutrophil, lymphocyte, mean platelet volume (MPV), COHb and red cell distribution width (RDW) levels at the index admission following CO poisoning than patients with negative troponin (p < 0.05). Age, COHb level, CO exposure time, MPV and RDW (p = 0.001, p < 0.05) remained associated with an increased risk of troponin positivity following adjustment for the variables that were statistically significant. CONCLUSIONS In patients presenting to the ED with CO poisoning, RDW and MPV can be helpful for risk stratification of neuropsychosis.

Atrial Fibrillation at a Very Young Age

Atrial fibrillation is the most common rhythm disturbance in general population. We present a 19-year-old man who was admitted to emergency department with progressive weakness, intermittent nausea, vomiting, and palpitations for 1-2 hours. He stated that he had palpitations for the first time. His past history was notable for venlafaxine use for panic disorder. He was diagnosed with AF with rapid ventricular rate and admitted to coronary care unit. Medical cardioversion with amiodarone was attempted and normal sinus rhythm was restored. He had no additional problems during hospital stay and was discharged on anticoagulant therapy (warfarin sodium). Atrial fibrillation should be born in mind in cases presenting to emergency department with palpitations, chest pain, syncope, or weakness in order to provide early diagnosis and treatment for this important disorder causing many complications.