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Background/Aims: In pediatric forearm fractures, the choice of surgical technique and fixation method can be challenging. Surgically treated pediatric patients younger than 14 years with Titanium Elastic Nails (TEN) or Plate Screw Fixation(PSF) were compared clinically, in cost, and in terms of postoperative outcomes. Method: In the retrospective case-control study, pediatric forearm fractures operated on at a level I trauma center between 2017 and 2022 were examined. Surgically treated forearm fractures in pediatric patients under 14 years of age were included in this study group. Results: A mean age of 10.83 +- 3.28 years was found among the 109 patients. The PSF group (12.87+-2.76 years) was 3.17 (95% CI 2.02 - 4.33) years older than the TEN group (9.7+-3 years) (p

Aims: All patients requiring emergency intervention are given their first medical attention in the emergency department, regardless of the facilities, equipment, and occupancy of the hospital. When the hospital facilities are not sufficient, interhospital patient transfers may be done under some regulations and legislations. This study aimed to analyze interhospital patient transfers from emergency departments to other hospitals. Materials and methods: This retrospective, observational, descriptive study examined interhospital patient transfers from İstanbul Emergency Department to other hospitals for four years (2018–2022). While all referrals made by the emergency service through the Arnavutköy State Hospita 112 Provincial Ambulance Service Transport Unit were eligible for the study, patients under the age of 18, those whose referral was due to COVID-19 infection, and those whose data could not be accessed were excluded. In addition to demographic data, interhospital patient transfers were evaluated according to time, department, diagnosis, distance between hospitals, and the characteristics of the referral institution. Results: The study included 4,280 transfers. Transfers were done most frequently in 2018 (1,310; 30.6%). Transfers were often handled outside of weekday daytime (2,919; 68.2%) and were most frequently done for cardiac events (2,592; 60.6%). The average transfer distance between hospitals was calculated as 24.29 km (standard deviation [SD]: 6.55 km), while the mean time between the first registration and the transfer was 344.8 minutes (SD: 275.3 minutes). In the analysis of transfers by year, a higher rate of transfers were to public institutions in each successive year (2018: 40.8%; 2019: 52.4%; 2020: 77.8%; 2021: 78.3%). Conclusion: The most common reason for transfer was cardiac events. Increasing the cardiology facilities and equipment of the hospital could reduce the number of interhospital patient transfers.

Objective: The aim of this study is to analyze the diagnostic value of Quick Sequential Organ Failure Assessment (qSOFA), modified qSOFA, National Early Warning Score (NEWS) and NEWS + Lactate (NEWS + L) scores in the detection of severe community-acquired pneumonia (CAP). Methods: This research is a retrospective cohort study. Patients admitted to the Emergency Department (ED) with the diagnosis of CAP were divided into severe and mild pneumonia regarding their Pneumonia Severity Index (PSI) scores. The accuracies of lactate, procalcitonin (PCT) values, NEWS and qSOFA scores, as well as score combinations (NEWS + L and qSOFA + PCT) in predicting patients with severe CAP were analyzed. Results: Median qSOFA value in the severe CAP group (0 [IQR 0–1]) was found to be higher than median qSOFA value (0 [IQR 0-0]) in the mild CAP group (p

This compilation covers emergency medical management lessons from the February 6th Kahramanmaraş earthquakes. The objective is to review relevant literature on emergency services patient management, focusing on Koenig’s 1996 Simple Triage and Rapid Treatment (START) and Secondary Assessment of Victim Endpoint (SAVE) frameworks. Establishing a comprehensive seismic and mass casualty incident (MCI) protocol chain is the goal. The prehospital phase of seismic MCIs treats hypovolemia and gets patients to the nearest hospital. START-A plans to expedite emergency patient triage and pain management. The SAVE algorithm is crucial for the emergency patient secondary assessment. It advises using Glasgow Coma Scale, Mangled Extremity Severity Score, Burn Triage Score, and Safe Quake Score for admission, surgery, transfer, discharge, and outcomes. This compilation emphasizes the importance of using diagnostic tools like bedside blood gas analyzers and ultrasound devices during the assessment process, drawing from 6 February earthquake research. The findings create a solid framework for improving emergency medical response strategies, making them applicable in similar situations.

Aim: Liver transplantation (LT) has significantly improved patient outcomes, leading to increased numbers of LT recipients seeking emergency department (ED) care. However, there is a lack of comprehensive information regarding their outcomes and parameters influencing hospital admission decisions. This study aims to address the gap in knowledge by analyzing critical parameters influencing hospital admission decisions for LT recipients presenting at the ED. Materials and Methods: A retrospective observational case-control study was conducted with 247 consecutive LT patients who visited a tertiary care center’s ED between 2018 and 2023. Demographic information, transplantation details, presenting complaints, laboratory results, and ED outcomes were evaluated. Univariate analysis identified significant predictors for an artificial neural network (ANN) analysis to predict admission decisions. Results: Among 247 LT recipients presenting at the ED, 48.2% were admitted. The most common complaints among admitted patients were abdominal pain and fever. Patients admitted had higher levels of alanine aminotransferase, aspartate aminotransferase (AST), alkaline phosphatase, gamma-glutamyl transferase, and C-reactive protein (CRP) and lower levels of total protein and albumin compared to discharged patients. Ultrasonography findings of perihepatic fluid collection were more common in admitted patients. The ANN analysis identified total protein, conjugated bilirubin, CRP, total bilirubin, and AST as the most influential factors predicting hospital admission decisions. Conclusion: The ANN analysis identified total protein, conjugated bilirubin, CRP, total bilirubin, and AST influencing hospital admission decisions for liver transplant recipients in the ED. Emphasizing the significance of these parameters can guide evidence-based guidelines for improved patient care and resource allocation in emergency settings.

Background Seasonal viral outbreaks, exemplified by influenza A and B viruses, lead to spikes in emergency department (ED) visits, straining healthcare facilities. Addressing ED overcrowding has become paramount due to its implications for patient care and healthcare operations. Recurrent visits among influenza patients remain an underexplored aspect, necessitating investigation into factors influencing such revisits. Methods Conducted within a tertiary care university hospital, this study adopts an observational retrospective cohort design. The study included adult patients with acute respiratory symptoms diagnosed with influenza using rapid antigen testing. The cohort was divided into single and recurrent ED visitors based on revisits within 10 days of initial discharge. A comparative analysis was performed, evaluating demographics, laboratory parameters, and clinical process data between recurrent visitors and single visitors. Results Among 218 patients, 36.2% (n = 139) experienced recurrent ED visits. Age and gender disparities were not significant. Antibiotics were prescribed for 55.5% (n = 121) and antivirals for 92.7% (n = 202) of patients, with no notable influence on recurrence. Recurrent visitors exhibited lower monocyte counts, hemoglobin levels, higher PDW and P-LCR percentages, and increased anemia prevalence (p = 0.036, p = 0.01, p = 0.004, p = 0.029, p = 0.017, respectively). C-reactive protein (CRP) levels did not significantly affect recurrence. Conclusion This study highlights the pressing concern of recurrent ED visits among mild influenza patients, magnifying the challenges of ED overcrowding. The observed notable prescription rates of antibiotics and antivirals underscore the intricate landscape of influenza management. Diminished monocyte counts, hemoglobin levels, and altered platelet parameters signify potential markers for identifying patients at risk of recurrent visits.

Background Understanding mortality risk factors is critical to reducing mortality among elderly hip fracture patients. To investigate the effects of admission and post-operative levels of distribution width of red blood cells (RDW), albumin, and RDW/albumin (RA) ratio on predicting 1-year mortality following hip fracture surgery. Methods A retrospective study was conducted on 275 elderly patients who underwent hip fracture surgery in a tertiary hospital between January 2018 and January 2022. Deaths within one year of hip fracture were defined as the deceased group. The survivors were defined as those who survived for at least one year. The relationship between admission and post-operative levels of RDW, albumin, RA, and mortality within one year after hip surgery was assessed statistically, including binary logistic regression analysis. The study also assessed other factors related to mortality. Results One-year mortality was 34.7%. There was a 3.03-year (95% CI [1.32–4.75]) difference between the deceased (79.55 ± 8.36 years) and survivors (82.58 ± 7.41 years) (p

Background Rebleeding is associated with poor outcomes in upper gastrointestinal bleeding (UGIB). Identifying predictors of rebleeding can assist in risk assessment. The aim of the study is to investigate the factors affecting rebleeding in patients with UGIB admitted to the emergency department. Methods This retrospective, observational, cross-sectional study was conducted on patients with UGIB presented to the emergency department. Patients who did not arrest in the first 24 h, who were not diagnosed with GI malignancy, and who were clinically diagnosed with UGIB were included in the study. Patient demographic characteristics, hemodynamic parameters, patient parameters, and bleeding that may affect rebleeding were evaluated. The primary endpoint was rebleeding within 7 days. Results The study included 371 patients. A total of 55 patients (14.8%) had rebleeding within 7 days, and 62 patients (16.7%) presented without bleeding manifestations. Rebleeding rates were higher in those who presented with bloody or coffee-ground vomitus, had a diagnosis of cancer, had blood in their nasogastric tube, and had peptic ulcers due to endoscopy. Mean cell hemoglobin concentration, lymphocyte, albumin, and total protein values of patients with rebleeding were low; red blood cell distribution width, neutrophil count, platelet distribution width (PDW), and neutrophil lymphocyte ratio were high. In-hospital mortality and 30-day mortality values of patients with rebleeding were significantly increased. In the multivariate analysis, cancer, PDW, and total protein levels were statistically significant. Conclusion The presence of cancer, low total protein level, and high PDW are effective parameters in predicting 7-day rebleeding in patients with UGIB admitted to the emergency department.