BACKGROUND: Acute pancreatitis (AP) is a common inflammatory disease in the emergency department (ED). This study aims to assess the role of CRP and hematologic parameters in mild/severe AP patients and biliary/nonbiliary AP at the time of admission to the ED. METHODS: 168 patients who were diagnosed as AP in the ED, and as a control group, 100 patients were included in this study. At the time of application to the ED, the demographic information (age, sex) and the amylase, lipase, CRP, hematological parameters (WBC, MPV, RDW, PLT, NLR) of all patients and the control group were recorded and compared. According to the etiology of the patients, the patients were divided into biliary and nonbilary AP groups and according to the severity, they were divided into mild and severe AP groups, then, the same parameters were evaluated.RESULTS: Significant differences were found out between WBC, CRP, NLR, MPV and PLT values between patient and the control group (p<0.001). The length of hospitalization and the parameters were not significant between the biliary and the nonbiliary group. Ranson and APACHE II scores were correlated with WBC, CRP and NLR. There was a statistically significant difference between the mild and severe AP groups in terms of duration of the hospital stay, CRP, WBC and NLR values (p=0.003 for CRP, p<0.001 for the others). In severe AP, the cut-off value of NLR was found to be 8.05, sensitivity %93.48, specificity %86.89 and AUC 0.937 (p<0.001). CONCLUSION:The use of parameters, such as WBC, CRP, and NLR, in combination with other diagnostic and prognostic tools in emergency service can provide convenience to clinicians at the time of admission and prognosis.
Objective: The aim of this study was to describe the relative change in the presentations to the emergency department owing to the COVID-19 pandemic and to reveal the profile of patients presenting to the emergency department. Methods: The data of patients who presented to the emergency department during a specific period of the pandemic and non-pandemic period were retrospectively analyzed. Results: The rate of patient presentation to emergency department was 69.6% in the non-pandemic period, it was calculated to be 30.4% in the pandemic period (p < 0.001). The rate of patients transferred by an ambulance, rate of presentation of “very urgent” patients, rate ofhospitalized patients, and mortality rate were higher during the pandemic period (p < 0.001).The total invoice amount was higher in patients who presented during the non-pandemic period, and the mean invoice amount was higher in patients who presented during the pandemic period (p < 0.001). Patients who presented during the pandemic period had a higher risk of being transferred to emergency department by an ambulance (OR 9.947, CI 8.65–11.44), being in the very urgent triage category (OR 1.892, CI 1.712–2.09), and in-hospital mortality (OR 2.263, CI 1.69–3.03), and the total invoice amount increased by 1.004 times foreach unit increase. Conclusion: During the pandemic period, although the rates of general patient presentation and non-urgent patient presentation to emergency department decreased, the presentation rate of “very urgent” patients, mortality, and cost per patient increased.
Objectives: This study was designed to investigate the possible relationship between the anatomical location of the PFF (head-neck fractures) and the demographic features, comorbidities, and risk factors of elderly patients. Methods: 233 patients aged 65 years and over, who were admitted to the emergency department with a diagnosis of proximal femur fracture were included in this study. Results: Most patients (59.6%) had a trochanteric fracture. The incidence of trochanteric fractures had a statistically significant positive correlation with age. Falls at ground level were found to be highly associated with trochanteric fractures (92,8%). At least one complication was observed in 57 (41,0%) cases and 31 (22,3%) died in one year, of the patients with trochanteric fractures. Comorbidity was not related to fracture location statistically. Fall ground level (p = 0.013), complication rate (73.7%; p <0.001), and Charlesen comorbidity index (p = 0.019) were statistically significantly associated with death. The logistic regression analysis of variables determined that only the quantity of comorbidities may be related to femoral neck fractures (p = 0.047). Conclusion: Female patients with trochanteric fractures were found to be older than male patients. Fall ground level, mortality, and complications were more frequently seen in patients with trochanteric fractures. Level of Evidence II, Retrospective study.
Introduction: Many risk factors have been reported to be responsible for morbidity and mortality in motorcycle and electric bike (e-bike) accidents. This study aims to determine the associations between the demographic features of motorcycle or e-bike riders and clinical outcomes. Methods: This is a retrospective case-control study conducted in an academic emergency department (ED). All adult patients admitted to the ED due to motorcycle or e-bike accidents were included. Results: A total of 358 patients were included in the study. Of the patients, 100 (28.1%) required hospitalization where 58 (16.3%) required surgery. Injuries were related with the upper extremities (15.4%), head and neck (14.8%), and lower extremities (11.2%) in the patients. Nighttime accidents, alcohol use, and lack of protective equipment were related to multiple injuries, need for hospitalization, surgery, blood transfusion, and mortality (p0.05). Conclusion: Nighttime accidents, alcohol or drug use, and lack of protective equipment could lead to multiple injuries, need for hospitalization, surgery, blood transfusion, and mortality. Moreover, the risk of poor outcomes is similar between the motorcycle and e-bike riders. Keywords: Non Vehicle Traffic Accident, Motorcycle Accident, E- Bike Accident, Emergency Department
Anaphylaxis is a serious clinical condition that can affect all ages and many systems (skin, gastrointestinal system, respiratory and cardiovascular systems). There are a few case reports of cardiac and cerebrovascular complications due to the anaphylaxis and/or the treatment with epinephrine. A 69-year-old female patient with known coronary artery disease (CAD), coronary artery bypass graft (CABG), and diabetes mellitus (DM) was admitted to the emergency department. She was brought to the emergency service with the complaints of shortness of breath, swelling of the tongue and lip, widespread itching and nausea after the use of amoxicillin-clavulonic acid due to soft tissue infection. The patient was considered as having anaphylaxis. 0.5 mg intramuscular (IM) epinephrine was administered. Following the emergency electrocardiography (ECG), the rate was 140/min and the rhythm was evaluated as atrial fibrillation. We present a case of cardiovascular complications and acute ischemia stroke following intramuscular epinephrine administration with anaphylactic diagnosis in this study. As a result, anaphylaxis management is extremely important in elderly patients with preexisting cardiovascular conditions.
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