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Küçükceran K, Ayrancı MK, Girişgin AS, Koçak S, Dündar ZD, Koç O. The Effect of Out-of-Hours Admission on Mortality in Patients Who Underwent Thrombectomy Due to Ischemic Stroke. J Acute Med 2024; 14:20-27. [PMID: 38487760 PMCID: PMC10933590 DOI: 10.6705/j.jacme.202403_14(1).0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 03/17/2024]
Abstract
Background It is important to investigate the factors that may delay the diagnosis and treatment process of ischemic stroke. The aim of this study was to investigate whether in-hospital mortality increased in patients who presented to the emergency department out-of-hours and underwent thrombectomy. Methods A total of 59 patients who applied to the emergency department between January 1, 2018 and November 1, 2021 and underwent thrombectomy due to ischemic stroke were included in the study. Patient age, gender, thrombectomy success (successful recanalization), in-hospital mortality status, intracranial hemorrhage status after thrombectomy, and out-of-hours admission status were recorded and compared according to out-of-hours admission status. Results Twenty-seven (45.8%) patients were male, and the median age was 74 (61-81) years. Forty-two (71.2%) patients applied to the emergency department out-of-hours. In-hospital mortality occurred in 27 (45.8%) patients. There was no statistically significant difference in out-of-hours admission status between the non-survivor group and the survivor group (non-survivor: 24 [75%]; survivor: 18 [66.7%], p = 0.481). Nor was a statistically significant difference found in the intracranial hemorrhage complication rate of the patients admitted out-of-hours compared to the patients admitted during working hours (out-of-hours: 17 [40.5%]; during working hours: 6 [35.3%], p = 0.712). Conclusion No statistically significant difference was found in the rate of in-hospital mortality and intracranial bleeding complications in patients who underwent thrombectomy out of working hours compared to during working hours.
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Affiliation(s)
- Kadir Küçükceran
- Necmettin Erbakan University Emergency Department Faculty of Medicine, Konya Turkey
| | | | | | - Sedat Koçak
- Necmettin Erbakan University Emergency Department Faculty of Medicine, Konya Turkey
| | - Zerrin Defne Dündar
- Necmettin Erbakan University Emergency Department Faculty of Medicine, Konya Turkey
| | - Osman Koç
- Necmettin Erbakan University Neuroradiology Faculty of Medicine, Konya Turkey
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Küçükceran K, Ayrancı MK, Koçak S, Girişgin AS, Dündar ZD, Ataman S, Bayındır E, Karaçadır O, Tatar İ, Doğru M. An Evaluation of the National Early Warning Score 2 and the Laboratory Data Decision Tree Early Warning Score in Predicting Mortality in Geriatric Patients. J Emerg Med 2024; 66:e284-e292. [PMID: 38278676 DOI: 10.1016/j.jemermed.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/02/2023] [Accepted: 10/01/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Due to the high rate of geriatric patient visits, scoring systems are needed to predict increasing mortality rates. OBJECTIVE In this study, we aimed to investigate the in-hospital mortality prediction power of the National Early Warning Score 2 (NEWS2) and the Laboratory Data Decision Tree Early Warning Score (LDT-EWS), which consists of frequently performed laboratory parameters. METHODS We retrospectively analyzed 651 geriatric patients who visited the emergency department (ED), were not discharged on the same day from ED, and were hospitalized. The patients were categorized according to their in-hospital mortality status. The NEWS2 and LDT-EWS values of these patients were calculated and compared on the basis of deceased and living patients. RESULTS Median (interquartile range [IQR]) NEWS2 and LDT-EWS values of the 127 patients who died were found to be statistically significantly higher than those of the patients who survived (NEWS2: 5 [3-8] vs. 3 [1-5]; p < 0.001; LDT-EWS: 8 [7-10] vs. 6 [5-8]; p < 0.001). In the receiver operating characteristic curve analysis, the NEWS2, LDT-EWS, and NEWS2+LDT-EWS-formed by the sum of the two scoring systems-resulted in 0.717, 0.705, and 0.775 area under curve values, respectively. CONCLUSIONS The NEWS2 and LDT-EWS were found to be valuable for predicting in-hospital mortality in geriatric patients. The power of the NEWS2 to predict in-hospital mortality increased when used with the LDT-EWS.
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Affiliation(s)
- Kadir Küçükceran
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Mustafa Kürşat Ayrancı
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Sedat Koçak
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | | | - Zerrin Defne Dündar
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Sami Ataman
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Enes Bayındır
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Oğuz Karaçadır
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - İbrahim Tatar
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Mustafa Doğru
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
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Ayrancı MK, Küçükceran K, Koçak S, Girişgin AS, Dündar ZD. The Role of Procalcitonin/Albumin Ratio and CRP/Albumin Ratio in Predicting In-hospital Mortality in COVID-19 Patients. J Acute Med 2023; 13:150-158. [PMID: 38099207 PMCID: PMC10720914 DOI: 10.6705/j.jacme.202312_13(4).0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/19/2023] [Accepted: 02/16/2023] [Indexed: 12/17/2023]
Abstract
Background Hospitalized coronavirus disease 2019 (COVID-19) patients have higher mortality rates. Parameters to predict mortality are needed. Therefore, we investigated the power of procalcitonin/albumin ratio (PAR) and C-reactive protein/albumin ratio (CAR) to predict in-hospital mortality in hospitalized COVID-19 patients. Methods In this study, 855 patients were included. Patients' PAR and CAR values were recorded from the hospital information management system. The patients were evaluated in two groups according to their in-hospital mortality status. Results In-hospital mortality was observed in 163 patients (19.1%). The median PAR and CAR values of patients in the non-survivor group were statistically significantly higher than those of patients in the survivor group, PAR (median: 0.07, interquartile range [IQR]: 0.03-0.33 vs. median: 0.02, IQR: 0.01-0.04, respectively; p < 0.001); CAR (median: 27.60, IQR: 12.49-44.91 vs. median: 7.47, IQR: 2.66-18.93, respectively; p < 0.001). The area under the curve (AUC) and odds ratio (OR) values obtained by PAR to predict in-hospital mortality were higher than the values obtained by procalcitonin, CAR, albumin, and CRP (AUCs of PAR, procalcitonin, CAR, albumin, and CRP: 0.804, 0.792, 0.762, 0.755, and 0.748, respectively; OR: PAR > 0.04, procalcitonin > 0.14, CAR > 20.59, albumin < 4.02, and CRP > 63; 8.215, 7.134, 5.842, 6.073, and 5.07, respectively). Patients with concurrent PAR > 0.04 and CAR > 20.59 had an OR of 15.681 compared to patients with concurrent PAR < 0.04 and CAR < 20.59. Conclusions In this study, PAR was found to be more valuable for predicting in-hospital COVID-19 mortality than all other parameters. In addition, concurrent high levels of PAR and CAR were found to be more valuable than a high level of PAR or CAR alone.
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Affiliation(s)
- Mustafa Kürşat Ayrancı
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Kadir Küçükceran
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Sedat Koçak
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | | | - Zerrin Defne Dündar
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
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Avcı A, Özer MR, Küçükceran K, Yurdakul MS. Roles of CRP and Neutrophil-to-Lymphocyte Ratio in the Prediction of Readmission of COVID-19 Patients Discharged From the ED. J Acute Med 2022; 12:131-138. [PMID: 36761852 PMCID: PMC9815995 DOI: 10.6705/j.jacme.202212_12(4).0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 04/01/2022] [Accepted: 05/06/2022] [Indexed: 02/11/2023]
Abstract
Background Patient admissions beyond the capacity of emergency departments (EDs) have been reported since the coronavirus disease (COVID-19) pandemic. Thus, laboratory parameters to predict the readmission of patients discharged from the ED are needed. For this purpose, we investigated whether C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR) could predict the readmission of patients with COVID-19. Methods Patients aged >18 years who visited the ED in October 2020 and had positive polymerase chain reaction test results were evaluated. Among these patients, those who were not hospitalized and were discharged from the ED on the same day were included in the study. The patients' readmission status within 14 days after discharge, age, sex, complaint on admission, comorbidity, systolic blood pressure, diastolic blood pressure, fever, pulse, oxygen saturation level, CRP level, blood urea nitrogen level, creatinine level, neutrophil count, lymphocyte count, and NLR were recorded. Data were compared between the groups. Results Of the 779 patients who were included in the study, 359 (46.1%) were male. The median age was 41 years (range, 31-53 years). Among these patients, those who were not hospitalized and were discharged from the ED on logistic regression analysis, age, CRP level, NLR, loss of smell and taste, and hypertension had odds ratios of 2.494, 2.207, 1.803, 0.341, and 1.879, respectively. Conclusions The strongest independent predictor of readmission within 14 days after same-day ED discharge was age > 50 years. In addition, CRP level and NLR were the laboratory parameters identified as independent predictors of ED readmission.
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Affiliation(s)
- Ali Avcı
- Karaman Training and Research Hospital Emergency Department Karaman Turkey
| | - Muhammet Raşit Özer
- Karamanoğlu Mehmetbey University Emergency Department Faculty of Medicine, Karaman Turkey
| | - Kadir Küçükceran
- Necmettin Erbakan University Emergency Department Meram School of Medicine, Konya Turkey
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Küçükceran K, Ayrancı MK, Dündar ZD, Keklik Mİ, Vatansev H. The Role of NEWS2 + Lactate + D-Dimer in Predicting Intensive Care Unit Admission and In-Hospital Mortality of COVID-19 Patients. J Acute Med 2022; 12:60-70. [PMID: 35860710 PMCID: PMC9283119 DOI: 10.6705/j.jacme.202206_12(2).0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/13/2021] [Accepted: 09/03/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND We investigated the parameters of National Early Warning Score 2 (NEWS2) + lactate + D-dimer in predicting the intensive care unit (ICU) admission and in-hospital mortality in patients hospitalized with COVID-19. METHODS Patients, who applied to the emergency department of a tertiary university hospital and were taken to the COVID-19 zone with suspected COVID-19 between March 2020 and June 2020, were retrospectively examined. In this study, 244 patients, who were hospitalized and had positive polymerase chain reaction test results, were included. NEWS2, lactate, and D-dimer levels of the patients were recorded. Patients were grouped by the states of in-hospital mortality and ICU admission. RESULTS Of 244 patients who were included in the study, 122 (50%) were male, while their mean age was 53.76 ± 17.36 years. 28 (11.5%) patients were admitted to the ICU, while in-hospital mortality was seen in 14 (5.7%) patients. The levels of D-dimer, NEWS2, NEWS2 + lactate, NEWS2 + D-dimer, NEWS2 + lactate + D-dimer were statistically significantly higher in patients with in-hospital mortality and admitted to ICU ( p < 0.05). The area under the curve (AUC) values of D-dimer, lactate, NEWS2, NEWS2 + lactate, NEWS2 + D-dimer, NEWS2 + lactate + D-dimer in predicting ICU admission were as 0.745 (0.658-0.832), 0.589 (0.469-0.710), 0.760 (0.675-0.845), 0.774 (0.690-0.859), 0.776 (0.692-0.860), and 0.778 (0.694-0.862), respectively; while the AUC values of these parameters in predicting in-hospital mortality were found to be as 0.768 (0.671-0.865), 0.695 (0.563-0.827), 0.735 (0.634-0.836), 0.757 (0.647-0.867), 0.752 (0.656-0.848), and 0.764 (0.655-0.873), respectively. CONCLUSIONS Compared to using the NEWS2 value alone, a combination of NEWS2, lactate, and D-dimer was found to be more valuable in predicting in-hospital mortality and ICU admission.
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Affiliation(s)
- Kadir Küçükceran
- Necmettin Erbakan University Emergency Department Meram School of Medicine, Konya Turkey
| | - Mustafa Kürşat Ayrancı
- Necmettin Erbakan University Emergency Department Meram School of Medicine, Konya Turkey
| | - Zerrin Defne Dündar
- Necmettin Erbakan University Emergency Department Meram School of Medicine, Konya Turkey
| | - Muhammed İdris Keklik
- Necmettin Erbakan University Emergency Department Meram School of Medicine, Konya Turkey
| | - Hülya Vatansev
- Necmettin Erbakan University Department of Chest Disease Meram School of Medicine, Konya Turkey
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Ayrancı MK, Küçükceran K, Dündar ZD. Comparison of Endotracheal Intubations Performed With Direct Laryngoscopy and Video Laryngoscopy Scenarios With and Without Compression: A Manikin-Simulated Study. J Acute Med 2021; 11:90-98. [PMID: 34595092 DOI: 10.6705/j.jacme.202109_11(3).0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/25/2020] [Accepted: 10/29/2020] [Indexed: 11/14/2022]
Abstract
Background Optimal management for trauma-induced coagulopathy (TIC) is a clinical conundrum. In conjunction with the transfusion of fresh-frozen plasma (FFP), additional administration of prothrombin complex concentrate (PCC) was proposed to bring about further coagulative benefit. However, investigations evaluating the efficacy as well as corresponding side effects were scarce and inconsistent. The aim of this study was to systematically review current literature and to perform a meta-analysis comparing FFP+PCC with FFP alone. Methods Web search followed by manual interrogation was performed to identify relevant literatures fulfilling the following criteria, subjects as TIC patients taking no baseline anticoagulants, without underlying coagulative disorders, and reported clinical consequences. Those comparing FFP alone with PCC alone were excluded. Comprehensive Meta-analysis software was utilized, and statistical results were delineated with odd ratio (OR), mean difference (MD), and 95% confidence interval (CI). I2 was calculated to determine heterogeneity. The primary endpoint was set as all-cause mortality, while the secondary endpoint consisted of international normalized ratio (INR) correction, transfusion of blood product, and thrombosis rate. Results One hundred and sixty-four articles were included for preliminary evaluation, 3 of which were qualified for meta-analysis. A total of 840 subjects were pooled for assessment. Minimal heterogeneity was present in the comparisons (I2 < 25%). In the PCC + FFP cohort, reduced mortality rate was observed (OR: 0.631; 95% CI: 0.450-0.884, p = 0.007) after pooling. Meanwhile, INR correction time was shorter under PCC + FFP (MD: -608.300 mins, p < 0.001), whilst the rate showed no difference (p = 0.230). The PCC + FFP group is less likely to mandate transfusion of packed red blood cells (p < 0.001) and plasma (p < 0.001), but not platelet (p = 0.615). The incidence of deep vein thrombosis was comparable in the two groups (p = 0.460). Conclusions Compared with FFP only, PCC + FFP demonstrated better survival rate, favorable clinical recovery and no elevation of thromboembolism events after TIC.
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Affiliation(s)
- Mustafa Kürşat Ayrancı
- Necmettin Erbakan University Meram Faculty of Medicine Emergency Medicine Department Konya Turkey
| | - Kadir Küçükceran
- Necmettin Erbakan University Meram Faculty of Medicine Emergency Medicine Department Konya Turkey
| | - Zerrin Defne Dündar
- Necmettin Erbakan University Meram Faculty of Medicine Emergency Medicine Department Konya Turkey
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Küçükceran K, Ayranci MK, Girişgin AS, Koçak S. Predictive value of D-dimer/albumin ratio and fibrinogen/albumin ratio for in-hospital mortality in patients with COVID-19. Int J Clin Pract 2021; 75:e14263. [PMID: 33891337 PMCID: PMC8250115 DOI: 10.1111/ijcp.14263] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/06/2021] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Due to the high mortality of coronavirus disease 2019 (COVID-19), there are difficulties in the managing emergency department. We investigated whether the D-dimer/albumin ratio (DAR) and fibrinogen/albumin ratio (FAR) predict mortality in the COVID-19 patients. METHODS A total of 717 COVID-19 patients who were brought to the emergency department from March to October 2020 were included in the study. Levels of D-dimer, fibrinogen and albumin, as well as DAR, FAR, age, gender and in-hospital mortality status of the patients, were recorded. The patients were grouped by in-hospital mortality. Statistical comparison was conducted between the groups. RESULTS Of the patients included in the study, 371 (51.7%) were male, and their median age was 64 years (50-74). There was in-hospital mortality in 126 (17.6%) patients. The area under the curve (AUC) and odds ratio values obtained by DAR to predict in-hospital mortality were higher than the values obtained by the all other parameters (AUC of DAR, albumin, D-dimer, FAR and fibrinogen: 0.773, 0.766, 0.757, 0.703 and 0.637, respectively; odds ratio of DAR > 56.36, albumin < 4.015, D-dimer > 292.5, FAR > 112.33 and fibrinogen > 423:7.898, 6.216, 6.058, 4.437 and 2.794, respectively). In addition; patients with concurrent DAR > 56.36 and FAR > 112.33 had an odds ratio of 21.879 with respect to patients with concurrent DAR < 56.36 and FAR < 112.33. CONCLUSION DAR may be used as a new marker to predict mortality in COVID-19 patients. In addition, the concurrent high DARs and FARs were found to be more valuable in predicting in-hospital mortality than either separately.
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Affiliation(s)
- Kadir Küçükceran
- Emergency DepartmentMeram School of MedicineNecmettin Erbakan UniversityKonyaTurkey
| | | | | | - Sedat Koçak
- Emergency DepartmentMeram School of MedicineNecmettin Erbakan UniversityKonyaTurkey
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Küçükceran K, Ayrancı MK, Girişgin AS, Koçak S, Dündar ZD. The role of the BUN/albumin ratio in predicting mortality in COVID-19 patients in the emergency department. Am J Emerg Med 2021; 48:33-37. [PMID: 33838471 PMCID: PMC8019653 DOI: 10.1016/j.ajem.2021.03.090] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/02/2021] [Accepted: 03/30/2021] [Indexed: 12/22/2022] Open
Abstract
Introduction Due to the high mortality and spread rates of coronavirus disease 2019 (COVID-19), there are currently serious challenges in emergency department management. As such, we investigated whether the blood urea nitrogen (BUN)/albumin ratio (BAR) predicts mortality in the COVID-19 patients in the emergency department. Methods A total of 602 COVID-19 patients who were brought to the emergency department within the period from March to September 2020 were included in the study. The BUN level, albumin level, BAR, age, gender, and in-hospital mortality status of the patients were recorded. The patients were grouped by in-hospital mortality. Statistical comparison was conducted between the groups. Results Of the patients who were included in the study, 312(51.8%) were male, and their median age was 63 years (49–73). There was in-hospital mortality in 96(15.9%) patients. The median BUN and BAR values of the patients in the non-survivor group were significantly higher than those in the survivor group (BUN: 24.76 [17.38–38.31] and 14.43 [10.84–20.42], respectively [p < 0.001]; BAR: 6.7 [4.7–10.1] and 3.4 [2.5–5.2], respectively [p < 0.001]). The mean albumin value in the non-survivor group was significantly lower than that in the survivor group (3.60 ± 0.58 and 4.13 ± 0.51, respectively; p < 0.001). The area-under-the-curve (AUC) and odds ratio values obtained by BAR to predict in-hospital COVID-19 mortality were higher than the values obtained by BUN and albumin (AUC of BAR, BUN, and albumin: 0.809, 0.771, and 0.765, respectively; odds ratio of BAR>3.9, BUN>16.05, and albumin<4.01: 10.448, 7.048, and 6.482, respectively). Conclusion The BUN, albumin, and BAR levels were found to be reliable predictors of in-hospital mortality in COVID-19 patients, but BAR was found to be a more reliable predictor than the BUN and albumin levels.
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Affiliation(s)
- Kadir Küçükceran
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey.
| | - Mustafa Kürşat Ayrancı
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | | | - Sedat Koçak
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Zerrin Defne Dündar
- Emergency Department, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
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Küçükceran K, Ayrancı MK, Dündar ZD. Comparison of cardiopulmonary resuscitation that applied synchronous 30 compressions–2 ventilations with that applied asynchronous 110/min compression–10/min ventilation: A mannequin study. HONG KONG J EMERG ME 2020. [DOI: 10.1177/1024907920958861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: CPR model of a resuscitation to be ventilated with a bag valve mask constitutes a discussion when evaluated with the current guidance. Objective: This study aims to compare the synchronous (30–2) ventilation–compression method with asynchronous 110/min compression–10/min ventilation in cardiac arrests where an advanced airway management is not applied and where ventilation is provided by a bag valve mask on a mannequin. Methods: This simulation trial was performed using two clinical cardiopulmonary resuscitation scenarios: an asynchronous scenario with 10 ventilations per minute asynchronously when compression is applied as 110 compression per minute and a synchronous scenario in which 30 compressions:2 ventilations were performed synchronously. A total of 100 people in 50 groups applied these two scenarios on mannequin. Ventilation and compression data of both scenarios were recorded. Results: Evaluating the compression criteria in both the scenarios performed by 50 groups in total, in terms of all criteria except compression fraction, there was no statistically difference between the two scenarios (p > 0.05). Compression fraction values in the asynchronous scenario were found to be statistically significantly higher than the synchronous scenario (96.02 ± 2.35, 81.34 ± 4.42, p < 0.001). Evaluating the ventilation criteria in both the scenarios performed by 50 groups in total; there was a statistically significant difference in all criteria. Mean ventilation rate of the asynchronous scenario was statistically higher than the synchronous scenario (7.22 ± 2.42, 5.08 ± 0.75, p < 0.001). Mean ventilation volume of the synchronous scenario was statistically higher than the asynchronous scenario (353.24 ± 45.46, 527.40 ± 96.60, p < 0.001). Ventilation ratio in sufficient volume of the synchronous scenario was statistically higher than the asynchronous scenario (36.84 ± 14.47, 75.00 ± 21.24, p < 0.001). Ventilation ratio below the minimum volume limit of the asynchronous scenario was statistically higher than the synchronous scenario (62.48 ± 14.72, 17.86 ± 19.50, p < 0.001). Conclusion: In our study, we concluded that the cardiopulmonary resuscitation applied by the synchronous method reached better ventilation volumes. Evaluating together with any interruption in compression, comprehensive studies are needed to reveal which patients would benefit from this result.
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Affiliation(s)
- Kadir Küçükceran
- Emergency Medicine, Critical Care, Trauma, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mustafa Kürşat Ayrancı
- Emergency Medicine, Critical Care, Toxicology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Zerrin Defne Dündar
- Emergency Medicine, Critical Care, Geriatric, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
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Küçükceran K, Ergin M, Kılınç İ, Karaibrahimoğlu A, Çolak T, Tuncar A, Dündar ZD, Koçak S, Girişgin AS, Gül M, Cander B. The role of soluble urokinase plasminogen activator receptor (SuPAR) as an indicator of
the severity of acute pancreatitis. Turk J Med Sci 2018; 48:1175-1181. [PMID: 30541244 DOI: 10.3906/sag-1709-134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim Soluble urokinase plasminogen activator receptor (suPAR) has been reported to have a positive correlation with the
activation degree of the immune system. This study’s aim is to investigate the efficiency of SuPAR serum levels in acute pancreatitis (AP)
patients in determining the severity of disease. Materials and methods This
prospective
research involves patients who arrived at the emergency service, were over 18 years old, had
nontraumatic abdominal pain and diagnosis of AP, and agreed to join the study. Demographic characteristics, contact information,
laboratory and imaging test parameters, Ranson’s criteria, the Balthazar Severity Index, the Rapid Acute Physiologic Score (RAPS), and
the modified Glasgow (Imrie) score of all patients were recorded. Two study groups were created as score of <3 (mild, Group I) and ≥3
(severe, Group II) for pancreatitis according to Ranson’s criteria. Results During the study period, 59 sequential patients with AP were included in the study. It was seen that 79.7% of the study group
(n = 47) were in Group I. Etiologically 67.8% (n = 40) cases were biliary and 32.3% (n = 19) were nonbiliary diseases. According to the
results, suPAR level was effective in distinguishing the severity of AP (AUC = 0.902, P < 0.001 (95% CI: 0.821–0.984)). With regard
to determining severe disease, suPAR had an optimum cutoff value of 6.815 ng/mL, sensitivity of 91.66%, specificity of 82.97%, and
negative predictive value of 97.5%. Conclusion Our study was performed the determine the efficiency of suPAR level in predicting severe disease in AP patients. We found
it significant in indicating the severity of disease according to the study results.
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Affiliation(s)
- Kadir Küçükceran
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Ergin
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - İbrahim Kılınç
- Department of Biochemistry, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Adnan Karaibrahimoğlu
- Department of Statistics, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Tamer Çolak
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Alpay Tuncar
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Zerrin Defne Dündar
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Sedat Koçak
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Abdullah Sadık Girişgin
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Gül
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Başar Cander
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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