OBJECTIVE: One of the major causes of emergency department (ED) visits is acute poisoning. Acute intoxications occur soon after either single or multiple exposures to toxic substances, and they started to be a more serious problem in developing countries. The objective of this study was to investigate the local patterns of acute intoxications, as well as clinical and sociodemographic characteristics of patients with acute poisoning, admitted to our hospital’s ED. METHODS: This single-center, retrospective study was conducted using medical records of consecutive patients admitted to the ED between January 2016 and December 2017. RESULTS: A total of 1344 patients were included in the statistical analysis. Of these, 673 (50.1%) were female. Mean (±SD) age was 32.2 (±12.0), ranging between 17 and 84 years. The highest number of poisoning cases was observed in summer, especially in July (10.0%) and August (11.8%), whereas lowest number of admissions related to poisoning occurred during winter in November (5.1%) and December (5.2%). Among admitted cases, many were suicide attempts (55.7%) followed by non-intentional (accidental) ingestion of non-pharmaceutical (n=553, 41.2%) and pharmaceutical agents (n=42, 3.1%). Single agents were the most common cause of acute intoxications (63.2%) rather than multidrug intoxications. Most frequently observed causes of poisonings were recreational substances (30.0%) and agents exposed by inhalation (13.2%). INR, lactate, and pH levels at admission were significant predictors of 7-day mortality without a significant paired difference between each other. The AUCs for each were 0.89 (SE 0.04; p<0.0001), 0.84 (SE 0.10; p=0.0007), and 0.79 (SE 0.11; p=0.0102), respectively. CONCLUSION: We conclude that recreational substances and medicinal drug intoxications were the leading cause of acute poisonings in our region, occurring mostly during the summer.
Introduction: A cluster of atypical pneumonia cases in Wuhan, China, turned out to be a highly contagious disease, swept across most of the countries, and soon after was announced as a pandemic. Therefore we aimed to investigate the demographics and factors associated with the disease outcome. Methods: In this retrospective chart review, we screened patients admitted to the emergency department with severe acute respiratory infection due to coronavirus disease 2019 (COVID-19) between March 15, 2020 and April 30, 2020. Age, gender, symptoms, laboratory data, and radiology data were obtained, as well as outcomes and length of stay. Results: We identified 177 patients (54.8% male). Seventy-eight percent of the cases were admitted into wards whereas 22% of the cases were admitted into the intensive care unit (ICU). Twenty-five percent of the cases needed invasive mechanical ventilation during their hospital stay and median length of hospital stay until death or discharge was eight days (interquartile range (IQR) 5.0 - 16.0). Among 177 patients, overall in-hospital mortality rate was 19.8% (n=35; male:female=18:17; p=0.6553). In-hospital mortality rates were statistically significantly higher in patients with higher age (64 vs. 74; p=0.0091), respiratory rate (RR) (28 vs. 36; p=0.0002), C-reactive protein (CRP) (54.7 vs. 104.0; p<0.0001), d-dimer (1.2 vs. 3.2; p<0.0001), ferritin (170 vs. 450.4; p<0.0001), fibrinogen (512 vs. 598; p=0.0349), international normalized ratio (INR) (1.1 vs. 1.3; p=0.0001), prothrombin time (PT) (14.8 vs. 17.4; p=0.0001), procalcitonin (0.1 vs. 0.3; p<0.0001), creatinine (0.9 vs. 1.1; p=0.0084), longer length of stay (LOS) (8.0 vs. 13.0; p=0.0251) with lower oxygen saturation (sO 2 ) (93.0% vs 87.5%; p<0.0001), diastolic blood pressure (DBP) (78 vs. 70; p=0.0039), lymphocyte (1.2 vs. 0.8; p=0.0136), and with positive polymerase chain reaction (PCR) results (28.6% vs. 12.8%; p=0.0118). Conclusion: Patients with older age, higher RR, lower sO 2 and DBP, higher creatinine, d-dimer, INR, CRP, procalcitonin, ferritin, and fibrinogen on initial admission were found to be less likely to survive COVID-19.
Envenomous viper snakes are not natural inhabitants of Istanbul, Turkey. The city is crowded and lacks an appropriate area for wild life. Viper snakes are mostly found in southern and middle rural Anatolia in Turkey. To our knowledge, viper bites have not been reported in our urban area previously. Here, we report a envenomous snakebite case, treated with polyvalent antivenom successfully. The snake was identified as Vipera Pontica, by the National Poisons Center.
Objective: In this study, we aimed to compare the utility of Revised Trauma Score (RTS), Glasgow Coma Scale, Age, and Systolic Blood Pressure (GAP) scores, and Emergency Trauma Score (EMTRAS) in multiple trauma patients for the prediction of mortality in the emergency department (ED). Materials and Methods: In this observational diagnostic accuracy study, a consecutive convenience sample of all adult patients (older than 16 years) with multiple trauma (injuries confined to at least two body regions) admitted to the trauma bay of the ED during the shifts of the researchers was used. Presence of ED mortality was recorded, and RTS, EMTRAS, and GAP scores were calculated at the analysis stage of this study. Results: The study sample included 279 multiple trauma patients. Of the 279 patients, 13 (4.7%) died in the ED. Among the 266 patients who survived to hospital admission, 3 were lost to-follow-up (foreigner patients). In the following 30 days, 28 more patients were lost, 23 in the Intensive Care Unit (ICU) (23/62, 37.1%), 4 in the wards (4/131, 3.1%), and 1 after discharge (1/73, 0.1%). The prognostic accuracies (AUC) of RTS, EMTRAS, and GAP were 0.92, 0.94, and 0.93, respectively, for ED mortality. Conclusion: In this study, all trauma scores performed similar in the ED for the prediction of ED mortality.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.