Pub Date : 2022-04-21DOI: 10.54996/anatolianjem.1057246
E. Karsli, N. Colak, Damla Anbarlı Metin, B. Bayram, H. Ellidokuz
Introduction Hypercapnic respiratory failure is defined as carbon dioxide (CO2) level >45 mmHg. High PaCO2 levels are related with increased mortality in acute exacerbation of COPD. In our study, we purposed to determine CO2 clearence value for predicting patients prognosis. Methods 68 patients were included in the study. Patients were divided in two groups according to outcome as good and bad prognosis group. Patients demographic information, comorbidities, vital parameters, on admission (first measurement) and in first sixth hour (second measurement) blood gas results, treatment given, and outcomes were saved to data form. Association between CO2 change and outcome was evaluated. Results There was no statistically significant difference in CO2 clearance and delta CO2 levels between the good and poor prognosis groups (11.7±12 vs 6.2 ± 23, p=0.205 and 11.8±12.9 mmHg vs -7.7±24.8 mmHg, p=0.281 respectively). NaHCO3 and pCO2 levels in second measurement was higher than first measurement in good prognosis group (23.9 ±5.3, 25.8±4.4, p
高碳酸血症性呼吸衰竭定义为二氧化碳(CO2)水平> 45mmhg。高PaCO2水平与COPD急性加重期死亡率增加有关。在我们的研究中，我们的目的是确定CO2清除率来预测患者的预后。方法选取68例患者作为研究对象。根据预后情况将患者分为预后良好组和预后不良组。将患者人口统计信息、合并症、生命参数、入院时(第一次测量)和入院前6小时(第二次测量)血气结果、给予的治疗和结果保存为数据形式。评估了CO2变化与预后之间的关系。结果预后良好组与预后不良组CO2清除率和δ CO2水平差异无统计学意义(11.7±12 vs 6.2±23,p=0.205; 11.8±12.9 mmHg vs -7.7±24.8 mmHg, p=0.281)。预后良好组第二次测定NaHCO3、pCO2水平高于第一次测定(23.9±5.3,25.8±4.4,p
{"title":"The Effect of Carbon Dioxide Clearance on Clinical Prognosis in Patient With Hypercapnic Respiratory Failure","authors":"E. Karsli, N. Colak, Damla Anbarlı Metin, B. Bayram, H. Ellidokuz","doi":"10.54996/anatolianjem.1057246","DOIUrl":"https://doi.org/10.54996/anatolianjem.1057246","url":null,"abstract":"Introduction \u0000Hypercapnic respiratory failure is defined as carbon dioxide (CO2) level >45 mmHg. High PaCO2 levels are related with increased mortality in acute exacerbation of COPD. In our study, we purposed to determine CO2 clearence value for predicting patients prognosis. \u0000Methods \u000068 patients were included in the study. Patients were divided in two groups according to outcome as good and bad prognosis group. Patients demographic information, comorbidities, vital parameters, on admission (first measurement) and in first sixth hour (second measurement) blood gas results, treatment given, and outcomes were saved to data form. Association between CO2 change and outcome was evaluated. \u0000Results \u0000There was no statistically significant difference in CO2 clearance and delta CO2 levels between the good and poor prognosis groups (11.7±12 vs 6.2 ± 23, p=0.205 and 11.8±12.9 mmHg vs -7.7±24.8 mmHg, p=0.281 respectively). NaHCO3 and pCO2 levels in second measurement was higher than first measurement in good prognosis group (23.9 ±5.3, 25.8±4.4, p","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122120384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-21DOI: 10.54996/anatolianjem.1058404
Ali Çelik, Mehmet Altuntaş
Purpose: This retrospective study aimed to investigate the combined accuracy of appendix diameter, C reactive protein, and Alvarado score in classifying the patients with negative appendectomy and acute appendicitis. Methods: This descriptive observational cohort study research was conducted at the Emergency Department of a Training and Research Hospital between November 2017 and April 2019. We included the data of appendicitis cases aged under 18 years in this retrospective study and gathered data on patients` demographics, preoperative laboratory values, signs, symptoms, and final pathological diagnosis, retrospectively. Then, cases were divided into acute appendicitis or negative appendectomy groups according to formal pathology reports. Results: The final study population consisted of 60 patients; the negative appendectomy rate was 25%. The multivariate model`s diagnostic accuracy involving CRP, Alvarado score, and appendix diameter was 93.3%, with sensitivity and specificity of 93.3% for identifying acute appendicitis (+LR: 14 and -LR: 0.07). Applying the model could had saved 93.3% of negative appendectomy cases (25% to 1.7%) from unnecessary surgery in our cohort. Conclusion: In conclusion, CRP, Alvarado score, or appendix diameter should not be used individually to diagnose AA in children. However, combining these variables can increase the accuracy of acute appendicitis diagnosis and may provide a significant reduction in negative appendectomy rates.
{"title":"Ultrason, Alvarado Skoru ve C-Reaktif Proteinin Pediatrik Appendectomilerdeki Prediktör Değeri","authors":"Ali Çelik, Mehmet Altuntaş","doi":"10.54996/anatolianjem.1058404","DOIUrl":"https://doi.org/10.54996/anatolianjem.1058404","url":null,"abstract":"Purpose: This retrospective study aimed to investigate the combined accuracy of appendix diameter, C reactive protein, and Alvarado score in classifying the patients with negative appendectomy and acute appendicitis. \u0000Methods: This descriptive observational cohort study research was conducted at the Emergency Department of a Training and Research Hospital between November 2017 and April 2019. We included the data of appendicitis cases aged under 18 years in this retrospective study and gathered data on patients` demographics, preoperative laboratory values, signs, symptoms, and final pathological diagnosis, retrospectively. Then, cases were divided into acute appendicitis or negative appendectomy groups according to formal pathology reports. \u0000Results: The final study population consisted of 60 patients; the negative appendectomy rate was 25%. The multivariate model`s diagnostic accuracy involving CRP, Alvarado score, and appendix diameter was 93.3%, with sensitivity and specificity of 93.3% for identifying acute appendicitis (+LR: 14 and -LR: 0.07). Applying the model could had saved 93.3% of negative appendectomy cases (25% to 1.7%) from unnecessary surgery in our cohort. \u0000Conclusion: In conclusion, CRP, Alvarado score, or appendix diameter should not be used individually to diagnose AA in children. However, combining these variables can increase the accuracy of acute appendicitis diagnosis and may provide a significant reduction in negative appendectomy rates.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129485498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-21DOI: 10.54996/anatolianjem.1035378
Necmi Baykan, Şule Yakar, Funda İpekten
Amaç: Taburculuk sonrası 72 saat içerisinde acil servise yapılan tekrarlayan başvuruların bakım kalitesi ile ilişkili olduğu bilinmektedir. Bu çalışmada pandemi sürecinde acil servise geriatrik hastalar tarafından yapılan tekrarlayan başvuruların değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Ocak 2019-Haziran 2020 tarihleri arasında Nevşehir Devlet Hastanesi’ne yapılan 65 yaş üstü hasta başvurularına ait sistem kayıtları retrospektif olarak değerlendirilmiştir. Bulgular: Hastaların demografik özellikleri, acil servise yapılan başvuru sayılarının aylık dağılımı yıllara göre incelenmiştir. Tekrar başvuru saatleri 0-24, 24-48 ve 48-72. saat aralıkları olarak gruplandırılmış, aylara ve yıllara göre dağılımı değerlendirilmiştir. Pandemi sürecinin bu dağılıma etkisi incelenmiştir. Sonuçlar: Pandemi sürecinin etkileri göz önünde bulundurularak; acil servise tekrarlayan başvurularla ilişkili faktörler ele alınıp bakım kalitesinin arttırılması ve acil servis kalabalığının azaltılmasına yönelik çözümler üretilmelidir.
{"title":"ACİL SERVİSE TEKRAR BAŞVURAN GERİATRİK HASTALARIN DEĞERLENDİRİLMESİ","authors":"Necmi Baykan, Şule Yakar, Funda İpekten","doi":"10.54996/anatolianjem.1035378","DOIUrl":"https://doi.org/10.54996/anatolianjem.1035378","url":null,"abstract":"Amaç: Taburculuk sonrası 72 saat içerisinde acil servise yapılan tekrarlayan başvuruların bakım kalitesi ile ilişkili olduğu bilinmektedir. Bu çalışmada pandemi sürecinde acil servise geriatrik hastalar tarafından yapılan tekrarlayan başvuruların değerlendirilmesi amaçlanmıştır. \u0000Gereç ve Yöntem: Ocak 2019-Haziran 2020 tarihleri arasında Nevşehir Devlet Hastanesi’ne yapılan 65 yaş üstü hasta başvurularına ait sistem kayıtları retrospektif olarak değerlendirilmiştir. \u0000Bulgular: Hastaların demografik özellikleri, acil servise yapılan başvuru sayılarının aylık dağılımı yıllara göre incelenmiştir. Tekrar başvuru saatleri 0-24, 24-48 ve 48-72. saat aralıkları olarak gruplandırılmış, aylara ve yıllara göre dağılımı değerlendirilmiştir. Pandemi sürecinin bu dağılıma etkisi incelenmiştir. \u0000Sonuçlar: Pandemi sürecinin etkileri göz önünde bulundurularak; acil servise tekrarlayan başvurularla ilişkili faktörler ele alınıp bakım kalitesinin arttırılması ve acil servis kalabalığının azaltılmasına yönelik çözümler üretilmelidir.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127909150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-11DOI: 10.54996/anatolianjem.1063767
Nafis Vural, Murat Duyan, Y. Cete
Aim: It is the determination of D-dimer threshold levels according to age in patients diagnosed with pulmonary embolism (PE) by pulmonary computed tomography (CT) angiography. Material and Methods: Patients with D-dimer levels and who underwent pulmonary angiography CT between January 01, 2015, and December 30, 2019, were included in the study. The demographic characteristics of the patients, imaging reports, and 1-month mortality of the patients were evaluated retrospectively by examining the hospital information management system and patient files. Patients with missing file data and imaging and laboratory studies other than the pre-diagnosis of PE were excluded from the study. Results: 2613 (41,9%) of the patients included in the study were male, and 362,8 (58,1%) were female. The mean age of the patients was 43.27±17.43 years. Pulmonary angiography was performed in 1507 (24,2%) patients. Of these 1507 patients, 147 (9,8%) had PE. When the 1-month mortality of 6240 patients, whose D-dimer level was requested with the preliminary diagnosis of PE, was examined, it was seen that 20 (0.3%) patients died. The 1-month mortality rate of patients with high D-dimer levels was 0.7% (17 patients), while the mortality rate of patients with normal D-dimer test results was 0.1% (3 patients). A weak but statistically significant correlation was found between the localization of the pulmonary embolism on pulmonary CT angiography and the D-dimer level spearman’s rho value of 0.251). The cut-off D-dimer value in predicting the presence of PE in all age groups was calculated as 1.34 mg/L. The cut-off values of D-dimer value to predict the presence of PE according to age ranges respectively 1.18 mg/L (80 years) was calculated as. Conclusion: As age increases, the D-dimer cut-off value for the diagnosis of PE also increases. There is a weak but significant correlation between D-dimer level and pulmonary embolism severity.
{"title":"Correlation of Pulmonary Embolism with D-dimer Level and Determination of Cut-off Values According to Age","authors":"Nafis Vural, Murat Duyan, Y. Cete","doi":"10.54996/anatolianjem.1063767","DOIUrl":"https://doi.org/10.54996/anatolianjem.1063767","url":null,"abstract":"Aim: It is the determination of D-dimer threshold levels according to age in patients diagnosed with pulmonary embolism (PE) by pulmonary computed tomography (CT) angiography. \u0000Material and Methods: Patients with D-dimer levels and who underwent pulmonary angiography CT between January 01, 2015, and December 30, 2019, were included in the study. The demographic characteristics of the patients, imaging reports, and 1-month mortality of the patients were evaluated retrospectively by examining the hospital information management system and patient files. Patients with missing file data and imaging and laboratory studies other than the pre-diagnosis of PE were excluded from the study. \u0000Results: 2613 (41,9%) of the patients included in the study were male, and 362,8 (58,1%) were female. The mean age of the patients was 43.27±17.43 years. Pulmonary angiography was performed in 1507 (24,2%) patients. Of these 1507 patients, 147 (9,8%) had PE. When the 1-month mortality of 6240 patients, whose D-dimer level was requested with the preliminary diagnosis of PE, was examined, it was seen that 20 (0.3%) patients died. The 1-month mortality rate of patients with high D-dimer levels was 0.7% (17 patients), while the mortality rate of patients with normal D-dimer test results was 0.1% (3 patients). A weak but statistically significant correlation was found between the localization of the pulmonary embolism on pulmonary CT angiography and the D-dimer level spearman’s rho value of 0.251). The cut-off D-dimer value in predicting the presence of PE in all age groups was calculated as 1.34 mg/L. The cut-off values of D-dimer value to predict the presence of PE according to age ranges respectively 1.18 mg/L (80 years) was calculated as. \u0000Conclusion: As age increases, the D-dimer cut-off value for the diagnosis of PE also increases. There is a weak but significant correlation between D-dimer level and pulmonary embolism severity.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"6 32","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132815781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-11DOI: 10.54996/anatolianjem.1024419
Selda Karaveli̇, Fatma Mutlu Kukul Güven
Aim: COVID-19 has caused concern to people and healthcare workers all over the world. Sharing the increasing number of cases and deaths in the media has increased the anxiety levels of health workers, especially related to their profession. This cross-sectional study was conducted to determine the occupational anxiety levels of the emergency room workers in a training and research hospital during the COVID-19 pandemic and to contribute to the literature by analyzing the related variables. Material and Methods: The population of the study consisted of the emergency service workers of a Training and Research Hospital. Data were collected by reaching 83.9% of the research population. The data of the research were obtained with the "Emergency Service Worker Information Form" and the "Occupational Anxiety Scale for Emergency Health Workers" and the online survey method prepared via Google forms. Descriptive statistics, Independent groups T-test, and one-way analysis of variance (One-Way ANOVA) test were used in the analysis of the data. Results: The mean age of the participants in the study was 33.71±8.13, and the mean age of working in the emergency department was 7.90±6.89 years. It was determined that 86.2% of the emergency service workers came into contact with a Covid-19 positive patient, and 31.9% had contact for longer than 8 hours. During the pandemic period, it was determined that 90.4% of the emergency service workers were worried about work, and 21.3% wanted to quit their job during this period. The occupational anxiety scale means a score of the personnel providing emergency health services was determined as 77.29±16.12. The occupational anxiety scale mean scores of female employees, singles, non-children, working on duty, doctors and nurses, and those who were worried about work during the pandemic period were found to be statistically significantly higher (p
{"title":"Evaluation of Occupational Anxiety in Emergency Service Workers in the COVID-19 Pandemic","authors":"Selda Karaveli̇, Fatma Mutlu Kukul Güven","doi":"10.54996/anatolianjem.1024419","DOIUrl":"https://doi.org/10.54996/anatolianjem.1024419","url":null,"abstract":"Aim: COVID-19 has caused concern to people and healthcare workers all over the world. Sharing the increasing number of cases and deaths in the media has increased the anxiety levels of health workers, especially related to their profession. This cross-sectional study was conducted to determine the occupational anxiety levels of the emergency room workers in a training and research hospital during the COVID-19 pandemic and to contribute to the literature by analyzing the related variables. \u0000Material and Methods: The population of the study consisted of the emergency service workers of a Training and Research Hospital. Data were collected by reaching 83.9% of the research population. The data of the research were obtained with the \"Emergency Service Worker Information Form\" and the \"Occupational Anxiety Scale for Emergency Health Workers\" and the online survey method prepared via Google forms. Descriptive statistics, Independent groups T-test, and one-way analysis of variance (One-Way ANOVA) test were used in the analysis of the data. \u0000Results: The mean age of the participants in the study was 33.71±8.13, and the mean age of working in the emergency department was 7.90±6.89 years. It was determined that 86.2% of the emergency service workers came into contact with a Covid-19 positive patient, and 31.9% had contact for longer than 8 hours. During the pandemic period, it was determined that 90.4% of the emergency service workers were worried about work, and 21.3% wanted to quit their job during this period. The occupational anxiety scale means a score of the personnel providing emergency health services was determined as 77.29±16.12. The occupational anxiety scale mean scores of female employees, singles, non-children, working on duty, doctors and nurses, and those who were worried about work during the pandemic period were found to be statistically significantly higher (p","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123386592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-20DOI: 10.54996/anatolianjem.1036089
Yunus Emre Özlüer, Fatma Dilan Güvenç
Amaç: Acil serviste yatış için bekleyen febril nötropeni hastalarında, bekleme süresi ile hastane içi mortalite ve hastanede yatış süresi arasında herhangi bir ilişki olup olmadığını saptamak. Gereç ve Yöntem: Aydın Adnan Menderes Üniversitesi Tıp Fakültesi Acil Tıp Ana Bilim Dalı’na 01.04.2015-01.08.2019 arasında başvuran febril nötropeni tanısı almış hastaların demografik özellikleri ile başvuru sırasındaki lökosit ve nötrofil değerleri, acil serviste antibiyotik ve koloni stimülan faktör uygulanıp uygulanmadığı, acil serviste yatış için bekleme süresi, hastaların acil servisten yatışının yapıldığı bölüm (servis/yoğun bakım), hastanede kalış süreleri ve hastane içi mortalite durumları kaydedildi. Elde edilen verilerin mortalite ile hastanede kalış süresi arasındaki ilişkisi analiz edildi. Bulgular: Çalışmaya dahil edilen 86 hastanın medyan yaşı 67 [IQR 17] ve erkek hasta oranı %52,3 (n=45) idi. Hastaların acil serviste yatış bekleme süresi medyan 6,7 [IQR 6,5] saat, solid organ malignitesi olan hasta sayısı 44 (%51,2), yoğun bakım yatışı yapılan hasta sayısı 20 (%23,3) olarak tespit edildi. Koloni stimülan faktör (CSF) uygulanan hasta sayısının 36 (%41,9), acil serviste antibiyotik tedavisi başlanan hasta sayısının 65 (%75,6) olduğu görüldü. Hastaların acil servise başvuru anındaki medyan lökosit sayısı 725/mm3 [IQR 705], medyan nötrofil sayısı ise 135/mm3 [IQR 237,5] olarak tespit edildi. Yapılan korelasyon analizinde acil serviste bekleyiş süresi ile hastane içi mortalite ve hastanede kalış süresi arasında bir korelasyon saptanmadı (sırasıyla p=0,480, p=0,768). Sonuçlar: Febril nötropeni hastaları için acil servislerde uygun izolasyon koşulları ve gerekli sağlık bakım standartlarının sağlanması halinde yatış için bekleme süresi hastane içi mortalite ve hastanede kalış süresini etkilememektedir.
{"title":"Febril Nötropeni Hastalarında Acil Serviste Yatış İçin Bekleme Süresi Mortaliteyi Artırmıyor","authors":"Yunus Emre Özlüer, Fatma Dilan Güvenç","doi":"10.54996/anatolianjem.1036089","DOIUrl":"https://doi.org/10.54996/anatolianjem.1036089","url":null,"abstract":"Amaç: Acil serviste yatış için bekleyen febril nötropeni hastalarında, bekleme süresi ile hastane içi mortalite ve hastanede yatış süresi arasında herhangi bir ilişki olup olmadığını saptamak. \u0000Gereç ve Yöntem: Aydın Adnan Menderes Üniversitesi Tıp Fakültesi Acil Tıp Ana Bilim Dalı’na 01.04.2015-01.08.2019 arasında başvuran febril nötropeni tanısı almış hastaların demografik özellikleri ile başvuru sırasındaki lökosit ve nötrofil değerleri, acil serviste antibiyotik ve koloni stimülan faktör uygulanıp uygulanmadığı, acil serviste yatış için bekleme süresi, hastaların acil servisten yatışının yapıldığı bölüm (servis/yoğun bakım), hastanede kalış süreleri ve hastane içi mortalite durumları kaydedildi. Elde edilen verilerin mortalite ile hastanede kalış süresi arasındaki ilişkisi analiz edildi. \u0000Bulgular: Çalışmaya dahil edilen 86 hastanın medyan yaşı 67 [IQR 17] ve erkek hasta oranı %52,3 (n=45) idi. Hastaların acil serviste yatış bekleme süresi medyan 6,7 [IQR 6,5] saat, solid organ malignitesi olan hasta sayısı 44 (%51,2), yoğun bakım yatışı yapılan hasta sayısı 20 (%23,3) olarak tespit edildi. Koloni stimülan faktör (CSF) uygulanan hasta sayısının 36 (%41,9), acil serviste antibiyotik tedavisi başlanan hasta sayısının 65 (%75,6) olduğu görüldü. Hastaların acil servise başvuru anındaki medyan lökosit sayısı 725/mm3 [IQR 705], medyan nötrofil sayısı ise 135/mm3 [IQR 237,5] olarak tespit edildi. Yapılan korelasyon analizinde acil serviste bekleyiş süresi ile hastane içi mortalite ve hastanede kalış süresi arasında bir korelasyon saptanmadı (sırasıyla p=0,480, p=0,768). \u0000Sonuçlar: Febril nötropeni hastaları için acil servislerde uygun izolasyon koşulları ve gerekli sağlık bakım standartlarının sağlanması halinde yatış için bekleme süresi hastane içi mortalite ve hastanede kalış süresini etkilememektedir.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128766944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-17DOI: 10.54996/anatolianjem.1052024
Yalçın Kara, Ömer Kılıç, Mahmut Can Kizil, Sabiha Şahin, Ener DINLEYICI, MD
Giriş: Kuduz, hem ülkemizde hem de dünyada aşı ve profilaksi uygulamaları ile önlenebilen, önlenemediği takdirde ölüm riski yüksek bir halk sağlığı sorunudur. Bu çalışmada hastanemiz çocuk acil servisine kuduz teması şüphesiyle başvuran çocukların klinik ve epidemiyolojik özelliklerini araştırmayı amaçladık. Gereç-Yöntem: Çalışmamızda Ocak 2013-Haziran 2021 tarihleri arasında Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Çocuk Acil Servisi'ne kuduz riski taşıyan bir hayvanla temas ile başvuran çocuk hastalar retrospektif olarak değerlendirildi. Çalışmaya dahil edilen 746 pediatrik olgunun epidemiyolojik ve klinik özelliklleri değerlendirildi. Bulgular: Çalışmaya alınan 746 olgunun %55'i erkekti ve yaş ortalaması 102 ay (4 ay-216 ay) idi. Vakaların %94'ü şehirde, %6'sı kırsalda ikamet etmektedir. Vakaların %54'ünde kedi, %46'sında köpek teması vardı. Temaslı hayvanların %84'ü sahipsizdi ve %89'u aşısızdı. Şüpheli kuduz temaslılarının %82'si kategori-2'de iken, %60'ında üst ekstremite teması ve %21'inde alt ekstremite teması vardı. Tüm olgularda yara temizliği yapılırken, %99'una kuduz aşısı, %10'una kuduz immünoglobulin, %32'sine tetanoz profilaksisi ve %21'ine antibiyotik tedavisi uygulandı. İmmünoglobulin, antibiyotik, tetanoz profilaksisi, dikiş atma ve hastaneye yatış, köpek temas grubunda kedi temas grubuna göre daha yüksekti. Her iki grupta da kuduz aşı takvimine uyum yüksekti. Sonuç: Çalışmamız, kuduz şüphesi olan temas vakalarının çoğunlukla sahipsiz ve aşısız hayvanlarla olması, sokak hayvanlarının aşılanması ve barındırılması gibi önlemlerin artırılması gerektiğini göstermektedir. Tüm dünya ve ülkemiz için halen ölümcül bir halk sağlığı sorunu olan kuduz, aşılama, temas sonrası korunma uygulamaları ve toplum eğitimi ile önlenebilir.
{"title":"Çocuk Acil Servise Şüpheli Kuduz Riskli Hayvan Temasıyla Başvuran Pediatrik Hastaların Değerlendirilmesi","authors":"Yalçın Kara, Ömer Kılıç, Mahmut Can Kizil, Sabiha Şahin, Ener DINLEYICI, MD","doi":"10.54996/anatolianjem.1052024","DOIUrl":"https://doi.org/10.54996/anatolianjem.1052024","url":null,"abstract":"Giriş: Kuduz, hem ülkemizde hem de dünyada aşı ve profilaksi uygulamaları ile önlenebilen, önlenemediği takdirde ölüm riski yüksek bir halk sağlığı sorunudur. Bu çalışmada hastanemiz çocuk acil servisine kuduz teması şüphesiyle başvuran çocukların klinik ve epidemiyolojik özelliklerini araştırmayı amaçladık. \u0000Gereç-Yöntem: Çalışmamızda Ocak 2013-Haziran 2021 tarihleri arasında Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Çocuk Acil Servisi'ne kuduz riski taşıyan bir hayvanla temas ile başvuran çocuk hastalar retrospektif olarak değerlendirildi. Çalışmaya dahil edilen 746 pediatrik olgunun epidemiyolojik ve klinik özelliklleri değerlendirildi. \u0000Bulgular: Çalışmaya alınan 746 olgunun %55'i erkekti ve yaş ortalaması 102 ay (4 ay-216 ay) idi. Vakaların %94'ü şehirde, %6'sı kırsalda ikamet etmektedir. Vakaların %54'ünde kedi, %46'sında köpek teması vardı. Temaslı hayvanların %84'ü sahipsizdi ve %89'u aşısızdı. Şüpheli kuduz temaslılarının %82'si kategori-2'de iken, %60'ında üst ekstremite teması ve %21'inde alt ekstremite teması vardı. Tüm olgularda yara temizliği yapılırken, %99'una kuduz aşısı, %10'una kuduz immünoglobulin, %32'sine tetanoz profilaksisi ve %21'ine antibiyotik tedavisi uygulandı. İmmünoglobulin, antibiyotik, tetanoz profilaksisi, dikiş atma ve hastaneye yatış, köpek temas grubunda kedi temas grubuna göre daha yüksekti. Her iki grupta da kuduz aşı takvimine uyum yüksekti. \u0000Sonuç: Çalışmamız, kuduz şüphesi olan temas vakalarının çoğunlukla sahipsiz ve aşısız hayvanlarla olması, sokak hayvanlarının aşılanması ve barındırılması gibi önlemlerin artırılması gerektiğini göstermektedir. Tüm dünya ve ülkemiz için halen ölümcül bir halk sağlığı sorunu olan kuduz, aşılama, temas sonrası korunma uygulamaları ve toplum eğitimi ile önlenebilir.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126270655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-03DOI: 10.54996/anatolianjem.1057387
Asım Enes Özbek, Onur Karakayali
Introduction: There is no fair predictor to determine the dehydration level in children. The objective of the study was to investigate the efficacy and reliability of the inferior vena cava collapsibility index by the use of ultrasonography to assess volume status for pediatric patients with acute gastroenteritis. Methods: This prospective study was conducted in a tertiary care hospital between December 2016 and October 2017. Patients were assessed with clinical dehydration scores and inferior vena cava collapsibility index was measured. The weights of the children were measured prior to treatment and one week after the improvement of symptoms. The correlation between the dehydration percentage seven days after symptom relief and inferior vena cava collapsibility index and also the correlation between clinical dehydration scale results and dehydration percentage seven days after symptom relief were determined. Results: 190 patients enrolled to the study. 130 (68.4%) patients were found to be mildly dehydrated while 60 (31.6%) patients’ dehydration levels remained moderate to severe, and of these 18 (9.4%) were severely dehydrated. The area under the curve for caval index was determined as 0.985 (95% CI; 0.959-1). The IVCCI cutoff of >58 produced 98.3% sensitivity, 88.5% specificity, 0.79 PPV, 0.99 NPV, 1.2 +LR, and 1.01 -LR. The AUC for moderate-to-severe dehydration was 0.778 (CI 95%: 0.703-0.854) according to the CDC and 0.764 (95% CI:0.669-0.889) for the Gorelick scale. Conclusion: USG-guided IVC index measurement is an effective and reliable method for determining the dehydration severity in pediatric patients present with acute gastroenteritis.
{"title":"İshalli çocuklarda dehidratasyonun değerlendirilmesi için inferior vena kava kollapsibilite indeksi ve klinik ölçeklerin karşılaştırılması","authors":"Asım Enes Özbek, Onur Karakayali","doi":"10.54996/anatolianjem.1057387","DOIUrl":"https://doi.org/10.54996/anatolianjem.1057387","url":null,"abstract":"Introduction: There is no fair predictor to determine the dehydration level in children. The objective of the study was to investigate the efficacy and reliability of the inferior vena cava collapsibility index by the use of ultrasonography to assess volume status for pediatric patients with acute gastroenteritis. \u0000Methods: This prospective study was conducted in a tertiary care hospital between December 2016 and October 2017. Patients were assessed with clinical dehydration scores and inferior vena cava collapsibility index was measured. The weights of the children were measured prior to treatment and one week after the improvement of symptoms. The correlation between the dehydration percentage seven days after symptom relief and inferior vena cava collapsibility index and also the correlation between clinical dehydration scale results and dehydration percentage seven days after symptom relief were determined. \u0000Results: 190 patients enrolled to the study. 130 (68.4%) patients were found to be mildly dehydrated while 60 (31.6%) patients’ dehydration levels remained moderate to severe, and of these 18 (9.4%) were severely dehydrated. The area under the curve for caval index was determined as 0.985 (95% CI; 0.959-1). The IVCCI cutoff of >58 produced 98.3% sensitivity, 88.5% specificity, 0.79 PPV, 0.99 NPV, 1.2 +LR, and 1.01 -LR. The AUC for moderate-to-severe dehydration was 0.778 (CI 95%: 0.703-0.854) according to the CDC and 0.764 (95% CI:0.669-0.889) for the Gorelick scale. \u0000Conclusion: USG-guided IVC index measurement is an effective and reliable method for determining the dehydration severity in pediatric patients present with acute gastroenteritis.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127337298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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