Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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2016 - 20202

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Subject: search.filters.subject.Emergency Service

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    Analysis of the Use of Resources and Features of Presentations and the Trends in Geriatric Patients Presenting to the Emergency Department: 2011-2015
    (2016) Akbuga Ozel, Betul; Mamak Ekinci, Elmas Burcu; Kayipmaz, Afsin Emre; Kocalar, Ummu Gulsum; Celikel, Elif; Kavalci, Cemil; 0000-0003-2529-2946; AAE-4242-2020; AAC-2597-2020; AGG-1308-2022
    Introduction: The purpose of the present study was to evaluate presentation and resource utilization at the emergency department by patients >= 65 years of age and the associated trends over the years. Materials and Method: This is a descriptive and retrospective study. Data related to patients >= 65 years of age who presented to emergency department of an urban university hospital between January 1, 2011 and December 31, 2015 were gathered from the hospital information management system. The data were analyzed using SPSS v17.0 software. Results: A total of 29,298 (20.3%) of emergency department visits were made by patients >= 65 years of age. The composition of this group of patients was predominantly female and within the 65-74-year-old age group. A 25% increase in the number of emergency department visits by geriatric patients was observed between 2011 and 2015. Among the geriatric presentations, 76.5% had urgent conditions and 9.3% were admitted to the hospital. Most of the non-urgent patients were females of 65-74 years of age (p<0.05). Female patients had the highest wait times before evaluation by a physician and the highest non-admission rates (p>0.05). Patients of 75-84 years of age had the highest total costs as a group, whereas patients >= 85 years of age had the highest per-patient costs. Conclusion: Resource utilization, length of emergency department stay, and hospital costs increased with geriatric patients' age. Analysis of the frequency of ED use and of resource utilization by geriatric patients would allow patient-centered and cost-effective planning for emergency department care.
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    Generalist versus Abdominal Subspecialist Radiologist Interpretations of Abdominopelvic Computed Tomography Performed on Patients with Abdominal Pain and its Impact on the Therapeutic Approach
    (2020) Yesilagac, Hasan; Arer, Ilker Murat; Gulalp, Betul; Yabanoglu, Hakan; Karagun, Ozlem; Karadeli, Elif; 0000-0003-0681-8375; 0000-0002-2045-2771; 0000-0002-0352-8818; 0000-0002-1365-9256; 0000-0002-1161-3369; 32322789; U-4084-2017; P-6931-2016; AAK-5399-2021; AAJ-6068-2021; AAJ-7865-2021
    Introduction: Abdominal pain is one of the most common patient complaints in the emergency department (ED) and abdominopelvic computed tomography (ACT) scan plays an important role in evaluation of these patients. Objective: The aim of this study was to determine the differences between interpretations by generalist radiologists and abdominal subspecialist radiologists regarding the abdominopelvic computed tomography (ACT) of patients who were admitted to the Emergency Department (ED) and to investigate its effect on the patients' therapeutic approach. Methods: The records of 16452 patients who were admitted to the emergency department with complaint of abdominal pain between January 2015 and April 2017 were reviewed, retrospectively. Out of these patients, 245 (1.5%) underwent ACT for differential diagnosis and among them, 137 (0.8%) patients had their ACT reports evaluated by generalist radiologists in 45 minutes and by abdominal subspecialist radiologist 8-12 hours later and were included in the study. Patients were divided into three groups according to the effect of ACT reports on the performed treatment. Group 1: no effect on planned treatment, group 2: minor effect on planned treatment, which did not result in a change in the treatment process and group 3: major effect on planned treatment approach, which resulted in a change in the treatment process. These changes included at least one of the two criteria: changing the indication of surgery from emergency surgery to elective surgery and/or discharge of the patient from the ED, when actually hospitalization was required. Results: Out of the 137 patients, 87 (63.5%) were male, 50 (36.5%) were female and the patients' mean age was 56 (27-93) years. There were 117 (85.4%) patients in group 1, 15 (10.9%) patients in group 2, and 5 (3.7%) patients in group 3. We determined minor inconsistency between the reports in group 2 and major inconsistency in group 3. Patients in group 3 suffered from delayed surgical intervention due to inconsistency of the CT reports resulting in prolonged hospital stay and increased morbidity. In 17 patients (four patients in Group 1 and 13 patients in Group 2) treatment plan was changed due to CT results; and while surgical treatment was planned for them prior to CT scan, they were discharged with medical treatment after that and overtreatment was prevented. Conclusion: Contribution of abdominal radiologists to evaluation of ACT images in the ED would reduce the inconsistency in ACT reports and prevent the patients from receiving insufficient treatment or overtreatment.