Hypouricemia prevalence has been reported in different clinical settings, but its prevalence and characteristics in the emergency department (ED) are limitedly studied. This study aimed to assess hypouricemia prevalence and clinical significance in the ED of a Turkish tertiary-care hospital. It was a retrospective, single-center observational study. Patients aged 18 years and older who presented to the ED between June 1, 2022 and June 1, 2023 were included. Data including age, gender, comorbid disease, final diagnosis, serum electrolytes, albumin, and serum uric acid (SUA) levels were obtained. SUA <2 mg/dL was considered as hypouricemia. The study included 35,923 patients, 362 of whom had SUA <2 mg/dL. The prevalence of hypouricemia was 1.008% and was higher in women (1.4% vs 0.4%, P < .001). Hypouricemic patients were younger than non-hypouricemic ones (34.5 [26–57] vs 50 [31–68], P < .001). Hypouricemic patients had a higher 6-month mortality rate than non-hypouricemic patients (5.2% vs 2.8%, P = .006). Among hypouricemic patients, men had a higher mortality rate than women (12.9% vs 3.4%, P = .004). A total of 33.7% of hypouricemic patients were pregnant, and the most common final diagnosis in the ED was abortus imminens, with 17.7%. The prevalence of hypouricemia in ED patients differs between genders. Hypouricemia increases 6-month mortality, more so in men. Obstetric pathologies are the most common final diagnosis of ED in hypouricemic patients. SUA can be monitored as a useful biomarker to ensure a healthy pregnancy and has a warning role in predicting mortality risk. Further studies are needed on hypouricemia.

Objective: To reveal the characteristics of patients needing neurosurgery by examining neurosurgery consultations within the emergency department (ED) admissions of a tertiary academic hospital. Method: This is a retrospective, single-centre observational study. Patients admitted to the ED between 01.01.2022 and 31.12.2022 and consulted to the neurosurgery department were identified through the hospital computer system and included in the study. The demographic information of the patients, mode of admission to the ED, the reasons for admission, the time of admission, the number of brain computed tomography (CT) scans, whether they underwent surgery or not, and the mortality results were recorded. Results: A total of 441 neurosurgery consultations were examined. Fall 35.6% (n=157) and traffic accident 16.6% (n=73) were the most common reasons for consultation. It was observed that 92.5% (n=408) of the patients had a brain CT scan, and 19.5% (n=86) had two or more brain CTs. It was determined that 12.7% (n=56) of the patients consulted for neurosurgery were operated on, and 4.1% (n=18) of the patients' hospital admissions resulted in death. Only 53.7% (n=237) of the patients who underwent neurosurgery consultation were discharged from the ED. It was determined that significantly more Neurosurgery consultations were requested during working hours (p = 0.013) Conclusion: Most consultation calls from the ED to neurosurgery are for trauma patients. Brain CT examination is frequently used in neurosurgical patient evaluation. As a result of the consultations, almost half of the patients are hospitalized. Emergency physicians can select patients who need neurosurgery well.

Objective: Literature lacks exploration of how the duration of low mean arterial pressure (MAP) affects mortality. This study aimed to determine whether the duration of MAP below 65 mmHg is associated with mortality in critically ill patients (CIPs). Methodology: A prospective observational study was conducted with patients who were admitted to the emergency department (ED) from July 1 to December 31, 2023, with a follow-up in the ED critical care unit for at least six hours. The average MAP and the total duration that the MAP remained below 65 mmHg (ΔtMAP<65) during this period were calculated. Results: In the study with 103 CIPs, ΔtMAP<65 was significantly higher in patients who died within 48 hours (247 [210-300] vs. 90 [30-135]) (p<0.001). ΔtMAP<65 was also significantly higher in patients who died within 30 days (195 [150-270] vs. 45 [15-75]) (p<0.001). Average MAP and ΔtMAP<65 highly predict 48 hours mortality, with AUC values of 0.887 and 0.957, respectively. ΔtMAP<65 for ≥180 minutes increased the risk of 48 hours mortality 173.25 (36.58-820.40) times. Average MAP and ΔtMAP<65 predicted 30 days mortality with AUC values of 0.890 and 0.963, respectively. ΔtMAP<65 for ≥135 minutes increased 30 days mortality 166.66 (20.78-1336.66) times. Conclusions: This study shows that the duration of MAP below 65 mmHg is associated with mortality in CIPs. When ΔtMAP<65, lasting over 135 minutes significantly increases the 30 days mortality risk. If it exceeds three hours, the 48 hours mortality risk also rises substantially. Monitoring cumulative hypotension duration in critical care may enhance survival through earlier interventions.

The emergency department (ED) plays a crucial role in evaluating patients with decreased general condition (DGC). Prompt diagnosis and precise risk stratification enhances clinical care outcomes. This study aimed to reveal which scoring system is better for predicting mortality in patients with DGC. This single-center prospective study was conducted between 1 March 2021 and 1 June 2021 in a tertiary university hospital’s ED. All patients presented with DGC were included. The scores assessed upon ED admission for patients include the Hypotension, Oxygen saturation, low Temperature, ECG changes, and Loss of independence, abbreviated as HOTEL score, Rapid Emergency Medicine Score (REMS), and the Worthing Physiological Scoring (WPS). The study aimed to compare the scoring systems to identify which is the best mortality predictor. Independent risk factors for 30-day mortality were analyzed using binary logistic regression and ROC curves to assess the effectiveness of HOTEL, REMS, and WPS scores in predicting mortality. The study was conducted with 137 DGC patients. The median age of patients presented to the ED with DGC was 77 (66.5–87), and 50.4% were male. 52.6% of patients died within one month. Analysis of mortality risk factors revealed that gender, age, day of admission, visit type, home oxygen, urinary catheter use, and speech status were not independent risk factors. For one-month mortality prediction, AUCs were: HOTEL 0.644 (cut-off 1), REMS 0.635 (cut-off 8), WPS 0.547 (cut-off 5). For mechanical ventilation: HOTEL 0.689 (10), REMS 0.790 (10), WPS 0.777 (4). For ICU admission: HOTEL 0.697 (2), REMS 0.770 (9), WPS 0.728 (4). Both the HOTEL and REMS scoring systems have moderate prognostic value in predicting mortality in patients with a DGC. The REMS, and WPS scores are also more helpful in determining the need for intensive care unit admission and mechanical ventilation.