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Coats T, Conroy S, de Groot B, Heeren P, Lim S, Lucke J, Mooijaart S, Nickel CH, Penfold R, Singler K, van Oppen JD, Polyzogopoulou E, Kruis A, McNamara R, de Groot B, Castejon-Hernandez S, Miro O, Karamercan MA, Dündar ZD, van Oppen JD, Pavletić M, Libicherová P, Balen F, Benhamed A, Dubucs X, Hernu R, Laribi S, Singler K, Fraidakis O, Fyntanidou VP, Polyzogopoulou E, Gaal S, Jónsdóttir AB, Kelly-Friel ME, McAteer CA, Sibthorpe LD, Synnott A, Zazzara MB, Coffeng SM, de Groot B, Lucke JA, Smits RAL, Castejon-Hernandez S, Llauger L, Mir SA, Ortiz MS, Padilla EE, Rodeles SC, Rojewski-Rojas W, Fadini D, Jegerlehner NS, Nickel CH, Rezzonico S, Zucconi EC, Cakmak S, Demir HA, Dündar ZD, Güven R, Karamercan MA, Sogut O, Tayfur I, Adams JA, Bernardo J, Brown L, Burton J, Butler MJ, Claassen RI, Compton F, Cooper JG, Heyes R, Ko S, Lightbody CJ, Masoli JAH, McKenzie STG, Mawhinney D, Moultrie NJ, Price A, Raman R, Rothwell LH, Shashikala RP, Smith EJ, Sorice V, van Oppen JD, Wallace JM, Young T, Benvin A, Breški E, Ćefo A, Dumić D, Ferenac R, Jurica I, Otočan M, Zinaić PŠ, Clement B, Jacquin L, Royer B, Apfelbacher SI, Bezati S, Gkarmiri S, Kaltsidou CV, Klonos G, Korka Z, Koufogianni A, Mavros V, Nano A, Ntousopoulos A, Papadopoulos N, Sason R, Zagalioti SC, Hjaltadottir I, Sigurþórsdóttir I, Skuladottir SS, Thorsteinsdottir T, Breslin D, Byrne CP, Dolan A, Harte O, Kazi D, McCarthy A, McMillan SS, Moiloa DN, O’Shaughnessy ÍL, Ramiah V, Williams S, Giani T, Levati E, Montenero R, Russo A, Salini S, van den Berg B, Booijen AM, Sir O, Vermeulen AE, ter Voert MA, Alvarez-Galarraga AC, Azeli Y, Gómez RGG, González González R, Lizardo D, Pérez ML, Madan CN, Medina JÁ, Moreno JS, Patiño EVB, Posada DMC, Rodrigo IC, Vitucci CF, Ballinari M, Dreher T, Gianinazzi L, Espejo T, Hautz WE, Rezzonico S, Bayramoğlu B, Cakmak S, Comruk B, Dogan T, Köse F, Allen TP, Ardley R, Beith CM, Boath KA, Britton HL, Campbell MMF, Capel J, Catney C, Clements S, Collins BP, Compton F, Cook A, Cosgriff EJ, Coventry T, Doyle N, Evans Z, Fasina TA, Ferrick JF, Fleming GM, Gallagher C, Golden M, Gorania D, Glass L, Greenlees H, Haddock ZP, Harris R, Hollas C, Hunter A, Ingham C, Ip SSY, James JA, Kenenden C, Jenkinson GE, Lee E, Lovick SA, McFadden M, McGovern R, Medhora J, Merchant F, Mishra S, Moreland GB, Narayanasamy S, Neal AR, Nicholls EL, Omar MT, Osborne N, Oteme FO, Pearson J, Price R, Sajan M, Sandhu LK, Scott-Murfitt H, Sealey B, Sharp EP, Spowage-Delaney BAC, Stephen F, Stevenson L, Tyrrell I, Ukoh CK, Walsh R, Watson AM, Whiteford JEC, Allston-Reeve C, Barson TJ, Giorgi MG, Godhania YL, Inchley V, Mirkes E, Rahman S. Prevalence of Frailty in European Emergency Departments (FEED): an international flash mob study. Eur Geriatr Med 2024; 15:463-470. [PMID: 38340282 PMCID: PMC10997678 DOI: 10.1007/s41999-023-00926-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/19/2023] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Current emergency care systems are not optimized to respond to multiple and complex problems associated with frailty. Services may require reconfiguration to effectively deliver comprehensive frailty care, yet its prevalence and variation are poorly understood. This study primarily determined the prevalence of frailty among older people attending emergency care. METHODS This cross-sectional study used a flash mob approach to collect observational European emergency care data over a 24-h period (04 July 2023). Sites were identified through the European Task Force for Geriatric Emergency Medicine collaboration and social media. Data were collected for all individuals aged 65 + who attended emergency care, and for all adults aged 18 + at a subset of sites. Variables included demographics, Clinical Frailty Scale (CFS), vital signs, and disposition. European and national frailty prevalence was determined with proportions with each CFS level and with dichotomized CFS 5 + (mild or more severe frailty). RESULTS Sixty-two sites in fourteen European countries recruited five thousand seven hundred eighty-five individuals. 40% of 3479 older people had at least mild frailty, with countries ranging from 26 to 51%. They had median age 77 (IQR, 13) years and 53% were female. Across 22 sites observing all adult attenders, older people living with frailty comprised 14%. CONCLUSION 40% of older people using European emergency care had CFS 5 + . Frailty prevalence varied widely among European care systems. These differences likely reflected entrance selection and provide windows of opportunity for system configuration and workforce planning.
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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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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, 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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Karamercan MA, Dündar ZD, Ergin M, VAN Meer O, Body R, Harjola VP, Verschuren F, Christ M, Golea A, Capsec J, Barletta C, Garcia-Castrillo L, Altuncı YA, Katırcı Y, Kelly AM, Laribi S. Seasonal variations of patients presenting dyspnea to emergency departments in Europe: Results from the EURODEM Study. Turk J Med Sci 2020; 50:1879-1886. [PMID: 32562519 PMCID: PMC7775711 DOI: 10.3906/sag-2002-221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/18/2020] [Indexed: 12/02/2022] Open
Abstract
Background/aim To describe seasonal variations in epidemiology, management, and short-term outcomes of patients in Europe presenting to an emergency department (ED) with a main complaint of dyspnea. Materials and methods An observational prospective cohort study was performed in 66 European EDs which included consecutive patients presenting to EDs with dyspnea as the main complaint during 3 72-h study periods. Data were collected on demographics, comorbidities, chronic treatment, prehospital treatment, mode of arrival of patient to ED, clinical signs at admission, treatment in the ED, ED diagnosis, discharge from ED, and in-hospital outcome. Results The study included 2524 patients with a median age of 69 (53–80) years old. Of the patients presented, 991 (39.3%) were in autumn, 849 (33.6%) were in spring, and 48 (27.1%) were in winter. The winter population was significantly older (P < 0.001) and had a lower rate of ambulance arrival to ED (P < 0.001). In the winter period, there was a higher rate for lower respiratory tract infection (35.1%), and patients were more hypertensive, more hypoxic, and more hyper/hypothermic compared to other seasons. The ED mortality was about 1% and, in hospital, mortality for admitted patients was 7.4%. Conclusion The analytic method and the outcome of this study may help to guide the allocation of ED resources more efficiently and to recommend seasonal ED management protocols based on the seasonal trend of dyspneic patients.
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Affiliation(s)
| | - Zerrin Defne Dündar
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Ergin
- Department of Emergency Medicine, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Oene VAN Meer
- Department of Emergency Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Richard Body
- Department of Emergency Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK,Department of Cardiovascular Sciences, The University of Manchester, Manchester, UK
| | - Veli-Pekka Harjola
- Department of Emergency Medicine, Faculty of Medicine, University of Helsinki, Helsinki, Finland,Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland
| | - Franck Verschuren
- Department of Acute Medicine, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Micheal Christ
- Department of Emergency Medicine, Luzerner Kantonsspital, Luzern, Switzerland
| | - Adela Golea
- Department of Emergency Medicine, County Emergency Hospital Cluj-Napoca, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Jean Capsec
- Department of Public Health, Tours University Hospital, Tours, France
| | - Cinzia Barletta
- Department of Emergency Medicine, Santa Eugenio Hospital, Rome, Italy
| | | | - Yusuf Ali Altuncı
- Department of Emergency Medicine, Faculty of Medicine Hospital, Ege University, İzmir, Turkey
| | - Yavuz Katırcı
- Department of Emergency Medicine, Ankara Education and Research Hospital, Ankara, Turkey
| | - Anne-Maree Kelly
- Joseph Epstein Centre for Emergency Medicine Research, Western Health, Melbourne, Australia,Department of Medicine, Melbourne Medical School – Western Precinct, The University of Melbourne, Melbourne, Australia
| | - Said Laribi
- Department of Emergency Medicine, Faculty of Medicine, Tours University, Tours, France
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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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Sönmez MG, Öztürk Sönmez L, Kozanhan B, Dündar ZD. Is There a Difference Between the Readabilities of Informed Consent Forms Used for Elective and Emergency Procedures in Turkey? Ther Innov Regul Sci 2019. [DOI: 10.1177/2168479019871040] [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: 11/16/2022]
Abstract
Background:Informed consent is an important aspect of ethical medical practice. In legal terms, making an intervention without informed consent may mean negligence or malpractice and may lead to legal action, maltreatment, and even attack against the doctor. This study aims to evaluate the readability of informed consent forms (ICFs) used for elective (urology and general surgery) and emergency procedures (emergency medicine and intensive care) by comparing through readability formulas.Methods:Elective and emergency ICFs were accessed through the web sites of national health care associations. A total of 387 consent forms were evaluated and the same forms were included only once. A total of 35 consent forms were evaluated for emergency procedures, while a total of 55 consent forms were evaluated for elective procedures. Ateşman and Bezirci-Yılmaz formulas defined for determining the readability level of Turkish texts and Gunning fog and Flesch Kincaid formulas measuring the general readability level were used for calculating the readability level of consent forms.Results:Even though elective ICFs are more readable compared to those of emergency procedures according to Bezirci-Yılmaz formulas, this was statistically insignificant ( P = .54). The readability of elective consent forms was found to be at a significantly more difficult level to read compared to Ateşman, Gunning fog, and Flesch Kincaid formulas ( P = .002, P < .001, P < .001, respectively).Conclusion:Even though the procedure is emergency or elective, a difficult readability level may cause problems for the doctor in legal phases. Readable and understandable consent forms should be available to be able to explain morbidity and mortality and improve prognosis. Education level of our country should also be considered while preparing these consent forms.
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Affiliation(s)
- Mehmet Giray Sönmez
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Leyla Öztürk Sönmez
- Department of Emergency Medicine, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
- Department of Physiology, Selcuklu Medical School, Selcuk University, Konya, Turkey
| | - Betül Kozanhan
- Department of Anesthesiology and Reanimation, University of Health Sciences, Konya Training and Research Hospital, Konya, Turkey
| | - Zerrin Defne Dündar
- Department of Emergency Medicine, Meram Medical Faculty, 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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Sönmez MG, Öztürk Sönmez L, Taşkapu HH, Kara C, Dündar ZD, Göğer YE, Evrin T, Öztürk A. Etiological factors and management in priapism patients and attitude of emergency physicians. ACTA ACUST UNITED AC 2017; 89:203-207. [PMID: 28969405 DOI: 10.4081/aiua.2017.3.203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 07/15/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To present the underlying etiological factors in patients referring with priapism, sharing how they are managed according to etiology and priapism type together with our experiences, creating awareness so that urologists and emergency physicians may play a more active role together in priapism management. MATERIALS AND METHODS Patients referring to emergency service with priapism were examined. Penile Doppler ultrasonography (PDU) and/or corporeal aspiration and blood gas analysis were made in order to determine priapism type after anamnesis and physical examination. The most appropriate treatment option was chosen and applied on the patients considering priapism type, underlying etiological factors and priapism time. Presence of a statistical difference between etiological factors causing priapism, priapism type and applied treatment methods was calculated using Chi square (χ2) test. RESULTS A total of 51 patients referring to emergency service with priapism attacks for 53 times were included in the evaluation. When compared to other etiological factors, number of priapism cases developing secondary to papaverine after PDU was found statistically significantly high (p < 0.001). Ischemic priapism ratio was detected statistically higher compared to other groups (p < 0.001). Aspiration and/or irrigation treatment were the most common method used for treatment at a statistically significant level (p < 0.001). All patients (100%) were hospitalized in urology service without applying any treatment in emergency service and had treatment and intervention under the control of the urologist. CONCLUSIONS Application of non-invasive treatments in suitable priapism patients would protect patients from invasive painful interventions. We believe that emergency physicians should be more effective in priapism phase management and at least noninvasive treatment phase.
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Affiliation(s)
- Mehmet Giray Sönmez
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, Konya.
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Dündar ZD, Ergin M, Kilinç İ, Çolak T, Oltulu P, Cander B. The role of oxidative stress in α-amanitin-induced hepatotoxicityin an experimental mouse model. Turk J Med Sci 2017; 47:318-325. [PMID: 28263509 DOI: 10.3906/sag-1503-163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 01/11/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM This study aimed to evaluate oxidative stress markers of liver tissue in a mouse α-amanitin poisoning model with three different toxin levels. MATERIALS AND METHODS The mice were randomly divided into Group 1 (control), Group 2 (0.2 mg/kg), Group 3 (0.6 mg/kg), and Group 4 (1.0 mg/kg). The toxin was injected intraperitoneally and 48 h of follow-up was performed before sacrifice. RESULTS Median superoxide dismutase activities of liver tissue in Groups 3 and 4 were significantly higher than in Group 1 (for both, P = 0.001). The catalase activity in Group 2 was significantly higher, but in Groups 3 and 4 it was significantly lower than in Group 1 (for all, P = 0.001). The glutathione peroxidase activities in Groups 2, 3, and 4 were significantly higher than in Group 1 (P = 0.006, P = 0.001, and P = 0.001, respectively). The malondialdehyde levels of Groups 3 and 4 were significantly higher than Group 1 (P = 0.015 and P = 0.003, respectively). The catalase activity had significant correlations with total antioxidant status and total oxidant status levels (r = 0.935 and r = -0.789, respectively; for both, P < 0.001). CONCLUSION Our findings support a significant role for increased oxidative stress in α-amanitin-induced hepatotoxicity.
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Affiliation(s)
- Zerrin Defne Dündar
- 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 Kilinç
- Department of Biochemistry, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Tamer Çolak
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Pembe Oltulu
- Department of Medical Pathology, 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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Tokur M, Ergin M, Okumuş M, Dündar ZD. An experimental comparative study on classic tube thoracostomy and thoracostomy with a newly designed thorax drainage catheter. Turk J Med Sci 2016; 46:91-6. [PMID: 27511340 DOI: 10.3906/sag-1405-75] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 06/11/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM The collection of fluids, blood, pus, or air in the pleural cavity is a pathological condition requiring pleural drainage. A newly designed thorax drainage catheter in the prototype phase was used in this experimental study to test its efficacy. MATERIALS AND METHODS A hemopneumothorax was first caused by a penetrating injury on the frontal axis of the sixth intercostal space on the right hemithorax with a scalpel on 6 female Sus domesticus swine subjects. After resting for 5 min, a tube or catheter was inserted. The same procedure with a tube thoracostomy or thorax drainage catheter was repeated on the left hemithorax. The time periods were recorded. After all procedures were completed, the thoracic organs were assessed for iatrogenic injuries. RESULTS In terms of time elapsed for procedure, statistically significant differences between the tube thoracostomy and thorax drainage catheter applications were identified (P < 0.05). Additional iatrogenic injuries were nonexistent for both groups. During the thorax drainage catheter application, a surgical set or the use of sutures was not required. CONCLUSION This study showed promising results regarding the efficacy of the thorax drainage catheter for convenient use in prehospital and hospital settings by physicians with little experience with tube thoracostomy.
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Affiliation(s)
- Mahmut Tokur
- Department of Thoracic Surgery, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Mehmet Ergin
- Department of Emergency Medicine, Faculty of Medicine, Near East University, Lefkoşa, Turkish Republic of Northern Cyprus
| | - Mehmet Okumuş
- Department of Emergency Medicine, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Zerrin Defne Dündar
- Department of Emergency Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Günaydın YK, Akıllı NB, Dündar ZD, Köylü R, Sert ET, Çekmen B, Akıncı E, Cander B. Antiepileptic drug poisoning: Three-year experience. Toxicol Rep 2014; 2:56-62. [PMID: 28962337 PMCID: PMC5598106 DOI: 10.1016/j.toxrep.2014.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 11/06/2014] [Accepted: 11/06/2014] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Antiepileptic drugs, which are also called anticonvulsants, are used in the therapy and prophylaxis of epileptic seizures. The purpose of this paper was to investigate the relevant epidemiological data and to determine which of these drugs was the most frequent cause of intoxication. Another purpose of this study was to determine the neurological, cardiac, and biochemical problems caused by antiepileptics. MATERIAL AND METHOD This retrospective study included 95 consecutive patients under 18 years of age with antiepileptic intoxication, presenting to and being followed-up in, the Toxicology Unit between January 2010 and February 2013. The data were obtained by screening the patient files. RESULTS Of the cases, 67 (70.5%) were self-poisoned by first generation antiepileptics (FGAEs) and 28 (29.5%) by second generation antiepileptics (SGAEs). The Glasgow Coma Scale (GCS) scores and the serum lactate levels of the patients poisoned by FGAEs and SGAEs on admission to emergency department were 15 (25th: 12; 75th: 15; 95th: 15; IQR: 3) and 1.9 (25th: 1.4; 75th: 3.1; 95th: 5.6; IQR: 1.7), and 15 (25th: 14.3; 75th: 15; 95th: 15; IQR: 0.75) and 1.07 (25th: 0.9; 75th: 1.6; 95th: 5.5; IQR: 0.71), respectively. The serum lactate levels of patients poisoned by FGAEs were significantly higher (p < 0.001). Among the cases poisoned by carbamazepine, the most frequent cause of intoxication, the GCS score was significantly lower and serum lactate level was significantly higher in the group with high serum levels of carbamazepine (p = 0.004 and p < 0.001, respectively). In cases poisoned by valproic acid (VPA), the second frequent cause of intoxication, there was neither a significant association between the serum VPA level and the GCS score, nor between the serum lactate level and the systolic blood pressure (p = 0.470, p = 0.897, and p = 0.088, respectively). However, there was a positive correlation between the serum VPA level and the serum ammonia level (kk = 0.742, p < 0.001). CONCLUSION First generation antiepileptics are more toxic than SGAEs. In patients with serum carbamazepine level, particularly those over 30 mg/L, serious disorders of consciousness, cardiovascular toxicity, and metabolic disorders may occur. In VPA intoxication, there is a positive correlation between the serum VPA levels and ammonia levels. On account of this finding, one should be more careful about hyperammonemic hepatic encephalopathy as the serum VPA level rises.
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Affiliation(s)
- Yahya Kemal Günaydın
- Konya Training and Research Hospital, Department of Emergency Medicine, Konya, Turkey
| | - Nazire Belgin Akıllı
- Konya Training and Research Hospital, Department of Emergency Medicine, Konya, Turkey
| | - Zerrin Defne Dündar
- Necmettin Erbakan University, Faculty of Medicine, Department of Emergency Medicine, Konya, Turkey
| | - Ramazan Köylü
- Konya Training and Research Hospital, Department of Emergency Medicine, Konya, Turkey
| | - Ekrem Taha Sert
- Konya Training and Research Hospital, Department of Emergency Medicine, Konya, Turkey
| | - Bora Çekmen
- Konya Training and Research Hospital, Department of Emergency Medicine, Konya, Turkey
| | - Emine Akıncı
- Keçiören Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey
| | - Başar Cander
- Konya Training and Research Hospital, Department of Emergency Medicine, Konya, Turkey
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Tokur M, Ergin M, Kürkçüoğlu IC, Dündar ZD. A pilot experimental study of a catheter to facilitate treatment for penetrating cardiac injury. Turk J Med Sci 2014; 44:935-940. [PMID: 25552144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND/AIM Penetrating heart injuries result in high mortality. We designed a new catheter to facilitate the treatment of penetrating cardiac injuries and provide more effective initial bleeding control and fluid replacement. MATERIALS AND METHODS The cardiac injury model was applied to 8 female 1-year-old Sus domesticus pigs. Subjects were grouped according to whether a Foley catheter or a newly designed catheter was placed into the heart through cardiac lacerations. Changes in systolic blood pressures, mortality, and problems encountered during surgery and other intraoperative findings were recorded. RESULTS There were higher mean blood pressure measurements in the newly designed catheter group during stages IV to VII. All subjects had tamponade and cardiac activity after completion of the repair of all lacerations in the catheter group, whereas in the other group only one subject did. Intraoperative direct fluid infusion to the heart through the catheters in the diastole was performed in all subjects of both groups. However, regurgitation from the cardiac cavity in the systole was seen only in the Foley catheter group. All of the intraoperative complications were seen in the same group.
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Affiliation(s)
- Mahmut Tokur
- Department of Thoracic Surgery, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
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Ertekin B, Koçak S, Dündar ZD, Girişgin S, Cander B, Gül M, Döşeyici S, Mehmetoğlu İ, Şahin TK. Diagnostic value of ischemia-modified albumin in acute coronary syndrome and acute ischemic stroke. Pak J Med Sci 2013. [DOI: 10.12669/pjms.294.3176] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Karabulut K, Gül M, Dündar ZD, Cander B, Kurban S, Toy H. Diagnostic and prognostic value of procalcitonin and phosphorus in acute mesenteric ischemia. ULUS TRAVMA ACIL CER 2011; 17:193-8. [PMID: 21935794 DOI: 10.5505/tjtes.2011.70493] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND In this study, using an animal model of acute mesenteric ischemia (AMI), we investigated the possible use of procalcitonin and phosphorus in the early diagnosis of AMI. METHODS In this study, 21 New Zealand rabbits were used. Subjects were allocated into three groups as Control, Sham and Ischemia. No intervention was performed in the subjects in the Control group. In the subjects in the Sham and Ischemia groups, laparotomy was performed with midline incision. In the Ischemia group, the superior mesenteric artery was found and tied after laparotomy. Blood was drawn from the animals in all groups at 0, 1, 3 and 6 hours, and procalcitonin and phosphorus levels were studied in these samples. RESULTS In the Ischemia group, the increase in the levels of serum phosphorus and procalcitonin was found to be statistically significant compared to the Control and Sham groups (p<0.05). The levels of phosphorus and procalcitonin were detected to increase from the 1st hour after ischemia onset, and the increase continued for the following 6 hours (p<0.05). CONCLUSION Phosphorus and procalcitonin may be important parameters for use in the early diagnosis and prognosis of AMI.
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Affiliation(s)
- Keziban Karabulut
- Department of Emergency Medicine, Selçuk University Meram Faculty of Medicine, Konya, Turkey.
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