Wos İndeksli Açık & Kapalı Erişimli Yayınlar
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Item NEUTROPHIL LYMPHOCYTE RATIO IN PREDICTING SEVERITY OF INJURY, COMPLICATIONS AND MORTALITY IN CAUSTIC INGESTION CASES(2020) Rezan, Karaali; Firdevs, Topal; Umut, Payza; Yesim, Akyol Pinar; Cemil, Kavalci; Zeynep, Karakaya; Esad, Topal FatihBackground: Caustic ingestion is still alife-threatening condition. In this study, we investigated the significance of the neutrophil lymphocyte ratio (NLR) in predicting the severity of the injury, complications and mortality at an early stage in the emergency department. Material and methods: 133 patients included in the study. Endoscopic findings and Complete Blood Count (CBC) parameters were retrieved from hospital files. The data were divided into two groups Zargar grade 0, land 2A as Group1, 2B, 3A and 3B as Group 2. The Zargar scores and the laboratory values were evaluated with Spearman's Correlation. Results: We found that NLR and White Blood Cells ( WBC) values of Group 1 cases were statistically significant and lower than NLR and WBC values of Group 2 cases (p<0,05). Values in Group 2 patients showed that AUC value for the 6.99 cut-off value of the NLR WaS 0.913 sensitivity 100% and specificity was 78,3% (p <0.05). The 0,801 AUC for the 11.9 value of the WBC, sensitivity 66,7 and specificity 84.4 were found to be statistically significant (p <0,05). NLR> 7,33 AUC 0,915 (p<0.05) and AUC value for WBC> 11,9 was found to be 0,870 (p <0.05 ) for the patients with late complications. Interns of mortality no statistical relationship was found (p> 0,05). Conclusion: Endoscopy (EGD) is the valid gold standard method to determine the injury. In the literature, which patient groups should undergo endoscopy is also unclear. In addition, performing endoscopy in each patient will increase both the cost and the possibility of endoscopy-related complications. In our study NLR was statistically significant in predicting the severity of injury and possibility of complications in corrosive ingestion. Moreover, it can be obtain through affordable and routine blood count.Item Results of Surgery in General Surgical Patients Receiving Warfarin: Retrospective Analysis of 61 Patients(2015) Belli, Sedat; Aytac, Huseyin Ozgur; Yabanoglu, Hakan; Karagulle, Erdal; Parlakgumus, Alper; Nursal, Tarik Zafer; Yildirim, Sedat; 25692422The aim of this study is to investigate postoperative complications, mortality rates, and to determine the factors affecting mortality on the patients receiving warfarin therapy preoperatively, as well as comparing the results obtained from emergency and elective surgeries. Surgical outcomes of 61 patients on long-term oral anticoagulation with warfarin who underwent surgery in our center were retrospectively reviewed over an 8-year period. Thirty-three (54.1%) patients were female, with a mean age of 53 years. Mitral valve replacement (62.3%) was the most frequent indication for chronic anticoagulation therapy. Twelve out of 61 (19.2%) patients underwent emergency surgery; 59 (96.7%) operations were classified as major surgery. We did not observe any thromboembolic events on patients receiving our bridging therapy protocol. Cardiopulmonary dysfunction (CPD; 19.7%) and hemorrhage (16.4%) were the most encountered postoperative complications. Presence of CPD, bleeding, endocarditis, and mortality were statistically significant for emergency surgeries when compared with the results obtained from elective surgeries. There were 5 (8.2%) deaths observed during follow-up. It was found that advanced age, prolonged duration of operations, and presence of CPD had a statistically significant effect on mortality (P < 0.05). The patients receiving oral anticoagulant had high postoperative complication and mortality rates. This case was more evident in emergency surgeries. It is recommendable that as mortality is more apparent in the patients who undergo emergency surgeries-being older, having long duration of operations as well as CPD. Therefore during the postoperative follow-up process, the patients should be closely monitored.Item Comparison of Different Suture Techniques(2015) Kavalci, Cemil; Cevik, Yunsur; Durukan, Polat; Sayhan, Mustafa BurakAim: Traumas are frequent causes of presentation to emergency departments. Suturing is usually required in treatment of patients with scalp laceration. This study aimed to investigate different suture methods with respect of patient satisfaction, wound healing, and treatment cost in patients with scalp laceration. Material and Method: A total of 60 patients were included in the study. The patients were divided into 3 groups; traditional suturing (Group 1), stapling (Group 2), and the tissue adhesive (Group 3) groups. Chi-Square and Kruskal-Wallis tests were used for comparison of the groups. A p value less than 0.05 was considered statistically significant. Results: Two-thirds of the patients were male. The patient satisfaction was highest in the Group 3 (p<0.05). Tissue adhesive group had the lowest treatment cost (p<0.05). Discussion: In contrast to existing traditional belief, the alternative suture methods, i.e. tissue adhesives and staples are not expensive. The patient satisfaction was highest in the tissue adhesive group.Item Estimation of the capacity of emergency surgery in Konya: Nine-year multicenter study(2016) Türk, Emin; Kucukkartallar, Tevfik; Cakir, Murat; Tekin, Ahmet; Balasar, Mehmet; Kartal, Adil; Koksal, Hande; Erengul, Bulent; 0000-0003-4766-3373; 28149121; AAJ-5609-2021Objective: Although the number of surgical emergencies continues to increase, comprehensive data on emergency surgical admissions are scarce. The aim of this multicenter study was to evaluate the causes, management, and outcomes of the general surgical emergencies in the city of Konya, Turkey. Material and Methods: The relevant details of the cases admitted and considered to be general surgical emergencies in Konya over a nine-year period (January 2003-January 2012) were analyzed. All demographic data were analyzed statistically. Results: The study group comprised 21954 cases from 4 hospitals in Konya: 7154 from Konya Numune Hospital, 6,654 from Konya Education and Research Hospital, 6,400 from Necmettin Erbakan University Meram Medical Faculty, and 1,390 from Baskent University Konya Education and Research Hospital. Their mean age was 59.6 years, and the average hospitalization time was 3.3 days. The diagnoses of the admitted patients were as follows: acute appendicitis (59.57%), bowel obstruction (11.12%), trauma (7.97%), strangulated inguinal hernia (5.46%), acute cholecystitis (4.87%), peptic ulcer perforation (4.09%), mesenteric ischemia (2.73%), necrotizing fasciitis (2.73%), gastrointestinal system bleeding (1.79%), and others (1.1%). Conclusion: The findings of the study indicate a steady increase in surgical admissions to emergency units. Nontraumatic acute abdomen was the most common reason for general surgical emergencies. Although the number of elderly patients increased, the hospital stay and mortality rates decreased over the study period.Item Cyanide ingestion(2017) Kayipmaz, Afsin Emre; Coskun, Abuzer; Ozkan, Fikret; Ozbay, Sedat; Okur, Osman Mahir; Gulunay, Behnan; Eren, Sevki Hakan; Ucar, Asuman; Kavalci, Cemil; AAC-2597-2020Cyanide is one of the oldest poisons. It has recently been introduced into industrial use in the gold enrichment process in gold mines. A 36-year-old man engaged in silver polishing business was brought to our emergency department by his colleagues with impaired consciousness and foamy saliva expectoration after accidentally drinking a sip of water mixed cyanide used for silver polishing. His general status was poor, and he was unconscious upon admission. The patient was administered the antidote three hours after his admission and extubated 11 hours after admission. His vital signs gradually returned to normal. On follow-up his urine color turned red; therefore, a second consultation was made with the poison information center, which recommended administering a second dose of antidote. After doing so, the patient gradually recovered, and he was discharged with normal liver enzymes, normal consciousness, and good overall status on 4th day of admission.Item Analysis of the patients admitted to emergency department due to urogenital trauma and investigation of factors that affect mortality(2017) Kavalci, Cemil; Sozen, Semih; Celik, Simsek; Akpinar, Cafer; Guven, Fatma Mutlu Kukul; Yel, Cihat; Sait, OmerObjective: To determine the general characteristics of urogenital trauma, and the factors that impact on mortality. Methods: Patients who were over 18 years of age admitted to the emergency service with urogenital injury between 1 January 2010 and 31 December 2014 were evaluated retrospectively. Age, gender, type of trauma, injured urogenital organs, vital parameters, additional organ injuries and mortality rate were investigated. Categorical variables were compared by using Chi-square test and comparing to groups data were performed with the Mann-Whitney and Kruskal-Wallis tests. P < 0.05 was considered statistically significant. Results: The median age of 174 patients was 35 years (interquartile range: 22), and 150 patients (86.2%) were males. It was determined that the incidence of urogenital trauma increased in August and September. The kidney was the most frequently injured organ (41.4%) and the most common cause of injury was traffic accidents (49.4%). Mean arterial pressure and revised trauma score were the lowest while pulse rate was the highest in renal trauma patients (P < 0.05). Mean arterial pressure, revised trauma score and respiratory rate were low in mortal group while pulse rate and Glasgow coma scale scores were significantly higher (P < 0.05). Conclusions: It is determined that the most common injured organs in trauma patients are kidneys and bladder and also no single factor is effective on mortality.Item Cost analysis and characteristics of the patients admitted to emergency service with poisoning(2018) Kilicli, Elif; Kavalci, Cemil; Findik, Meliha; Muratoglu, MuratObjective: To investigate the cost analysis and hospitalization rates and modes of poisoning of patients who applied to Bakent University Ankara Hospital Adult Emergency Service. Methods: Poisoning Patients who applied to emergency service due to suicide attempt between 01.01.2011-31.12.2014 were included in the study. Patients' age, gender, date of admission, definite diagnosis, the rate of hospitalization, and hospital costs were examined. A total of 646 patients were included in the study. 208 (32.2%) of the patients were male. The median age of the patients was 29 years. Results: The most causes of poisoning was drug intake. The median cost of the patients was 75.14 TL (IQR: 66.5). Conclusion: There was a positive correlation between age and cost (P<0.05). The majority of the patients apply to emergency dapartment with drug poisoning and female.Item Scoring systems in prediciting mortality rate of patients applying emergency department(2018) Cemil, Kavalci; Rezan, Tahtaci; Deniz, Arslan EnginObjective: To compare the scoring systems used in intensive care units in terms of predicting the mortality in emergency patients and to determine the most appropriate scoring system for urgent care. Methods: This study was carried out by retrospectively reviewing the files of patients admitted to Ankara Numune Training and Research Hospital emergency medicine clinic between October 1, 2010 and October 31, 2010 for non-traumatic reasons and admitted to any service of the hospital. This study calculated automatically with the data obtained from the patients files and records, and Acute Physiology and Chronic Health Evaluation (APACHE.), Simplified Acute Physiology Score (SAPS.), Modified Early Warning Score (MEW) and Sequential Organ Failure Assessment (SOFA) scores via internet. Patient files were reviewed and their outcomes (hospitalization, discharge, referral and mortality) were recorded. The obtained data were entered in SPSS 18 and compared with the scores of APACHE., SAPS., MEW and SOFA. Results: Based on area under the curve analysis, APACE. (0.799; 95% CI: 0.746 to 0.845) showed the biggest area under the curve in terms of predicting the patients mortality. However, there was no difference between four scoring system in terms of predicting the mortality. Age (P<0.001, odd's ratio 1.055) pulse (P<0.007, odd's ratio 1.025) and SO2 (P<0.003, odd's ratio 0.952) variables were found to be independent risk factors for mortality. Conclusions: Scores such as APACHE., SAPS., and SOFA, can not be used to make an urgent decision on the first encounter with the patient even though they are successful in predicting mortality. In this case, MEW could be recommended as the most useful system. As a result, the use of scoring systems in emergency departments is useful and necessary. But, multi-centered and large patient group studies are needed.