Background/Objectives: Trauma scoring systems are essential tools for predicting clinical outcomes in patients with multiple injuries. This study aimed to compare the performance of various anatomical and physiological scoring systems in predicting mortality among patients admitted to the emergency department following traffic accidents. Methods: In this prospective observational study, trauma patients presenting with traffic-related injuries were evaluated using seven scoring systems: ISS, NISS, AIS, GCS, RTS, TRISS, and APACHE II. Demographic data, clinical findings, and laboratory values were recorded. The prognostic performance of each score was assessed using ROC curve analysis, and diagnostic metrics including sensitivity, specificity, and likelihood ratios were calculated. Results: Among 554 patients included in the study, the overall mortality rate was 2%. The TRISS and GCS scores demonstrated the highest predictive performance, each with an AUC of 0.98, sensitivity of 100%, and specificity exceeding 93%. APACHE II followed closely with an AUC of 0.97, also achieving 100% sensitivity. NISS (AUC = 0.92) and ISS (AUC = 0.91) were effective anatomical scores, while RTS showed moderate predictive value (AUC = 0.90). Strong correlations were noted between ISS, NISS, and AIS (Rho > 0.85), while RTS was negatively correlated with these anatomical scores. All scoring systems showed statistically significant associations with mortality. Conclusions: TRISS, GCS, and APACHE II were the most effective trauma scoring systems in predicting mortality among emergency department patients. While complex models offer higher accuracy, simpler scores such as RTS and GCS remain valuable for rapid triage. The integration of both anatomical and physiological parameters may enhance early risk stratification and support timely decision-making in trauma care.

Background: Gastrointestinal (GI) bleeding is a common and potentially life-threatening condition frequently encountered in emergency departments (EDs). The optimal strategy for red blood cell suspension (RBCS) transfusion, including timing and location, remains unclear. This study aimed to evaluate the impact of transfusion location (ED vs. inpatient units) on mortality and hospital stay in patients with GI bleeding. Methods: A cross-sectional descriptive study was conducted in the ED of a tertiary care hospital. Patients admitted with GI bleeding between 1 June 2021, and 1 June 2023, who received RBCS transfusion were included. Data on demographics, laboratory parameters, transfusion details, and clinical outcomes were collected from the hospital information system. Logistic regression was used to identify mortality predictors. Results: A total of 244 patients were included. Patients transfused in the ED had a significantly shorter hospital stay compared to those transfused in inpatient units. However, mortality did not differ between the groups. Logistic regression identified age, albumin, hemoglobin, creatinine, and hospital stay as independent mortality predictors, while transfusion location was not significant. Conclusions: Early RBCS transfusion in the ED may reduce hospital stay but does not significantly impact mortality. Identifying mortality-associated factors is crucial for optimizing patient management. Further prospective studies are needed to clarify the role of transfusion location in GI bleeding outcomes.

Background: Gastrointestinal (GI) bleeding is a common and potentially life-threatening condition frequently encountered in emergency departments (EDs). The optimal strategy for red blood cell suspension (RBCS) transfusion, including timing and location, remains unclear. This study aimed to evaluate the impact of transfusion location (ED vs. inpatient units) on mortality and hospital stay in GI bleeding patients. Methods: A cross-sectional descriptive study was conducted in the ED of a tertiary care hospital. Patients admitted with GI bleeding between June 1, 2021, and June 1, 2023, who received RBCS transfusion were included. Data on demographics, laboratory parameters, transfusion details, and clinical outcomes were collected from the hospital information system. Logistic regression was used to identify mortality predictors. Results: A total of 244 patients were included. Patients transfused in the ED had a significantly shorter hospital stay compared to those transfused in inpatient units. However, mortality did not differ between groups. Logistic regression identified age, albumin, hemoglobin, creatinine, and hospital stay as independent mortality predictors, while transfusion location was not significant. Conclusions: Early RBCS transfusion in the ED may reduce hospital stay but does not significantly impact mortality. Identifying mortality-associated factors is crucial for optimizing patient management. Further prospective studies are needed to clarify the role of transfusion location in GI bleeding outcomes.

Background This study evaluates the effectiveness of trauma scoring systems in predicting mortality among patients admitted to the emergency department following traffic accidents. Methods A prospective cross-sectional study was conducted on multiple trauma patients at a tertiary university hospital from April 2022 to April 2023. Trauma scores, including ISS, NISS, AIS, GCS, RTS, and APACHE II, were calculated and analysed for their association with mortality. Demographic characteristics and comorbidities were also assessed. Results A total of 554 patients (median age: 36 years; 67.5% male) were included. Extremity injuries (61.7%) were the most common, followed by head and neck injuries (44%). Deceased patients exhibited significantly higher scores in APACHE II (median: 20 vs. 5, p < 0.001), ISS (median: 12 vs. 2, p < 0.001), NISS (median: 12 vs. 2, p < 0.001), and AIS (median: 2 vs. 1, p < 0.001), while RTS (median: 4.09 vs. 7.84, p < 0.001) and GCS (median: 4 vs. 15, p < 0.001) were lower. Hospitalized patients also had higher APACHE II, ISS, NISS, and AIS scores and lower GCS scores (p < 0.001 for all comparisons). Strong correlations were observed between ISS and NISS (Spearman’s Rho = 0.97, p < 0.001). Elevated WBC and reduced haematocrit and bicarbonate levels were significantly associated with mortality (p < 0.05). Conclusion RTS and APACHE II are practical tools for emergency departments, offering rapid physiological assessment and comprehensive evaluation, respectively. ISS and NISS remain reliable for predicting injury severity and mortality risk. Incorporating these scoring systems into trauma care protocols can enhance early risk stratification and inform clinical decision-making in emergency settings.

Background & Aim: Mechanical ventilatory support is frequently required in patients with acute respiratory distress syndrome (ARDS). However, early differences in ventilatory mechanics and severity scoring between COVID-19 and Non-COVID ARDS remain uncertain. This study aimed to compare respiratory parameters and clinical scores in COVID-19 and Non-COVID ARDS patients managed in the emergency department (ED) and to evaluate their association with in-hospital mortality. Methods: This prospective cohort study included adult patients diagnosed with ARDS (PaO₂/FiO₂ < 300 mmHg) who received mechanical ventilatory support in the ED. Initial respiratory parameters and clinical severity scores (SOFA, APACHE II, PSI) were recorded within the first 30 minutes. Patients were categorized into COVID-19 and Non-COVID groups, and outcomes were compared between survivors and non-survivors. Results: A total of 70 patients were included: 32 (45.7%) in the COVID-19 group and 38 (54.3%) in the Non-COVID group. Plateau pressure was significantly higher in the COVID-19 group (30.0 vs. 21.0 cmH₂O, p = 0.01), while static compliance was lower without statistical significance. No ventilatory parameter predicted mortality. Among clinical scores, SOFA was significantly higher in both COVID-19 patients and non-survivors. Additionally, APACHE II score was significantly higher in non-survivors within the COVID-19 group, suggesting its potential prognostic value. PSI did not show a significant difference. Conclusion: While COVID-19 patients had higher plateau pressures than Non-COVID patients, early respiratory mechanics were not associated with mortality. SOFA scores differed between groups without a significant association with outcome. Notably, APACHE II was the only scoring system that significantly predicted mortality within the COVID-19 group, suggesting its potential usefulness in early risk assessment.

Background and Aim: Mechanical ventilation is essential in conditions such as acute respiratory failure. However, prolonged use may lead to complications; therefore, there is a need for timely liberation. Special indicators are important for this purpose, including the Rapid Shallow Breathing Index (RSBI), the dead space to tidal volume ratio (VD/VT), and the Integrative Weaning Index (IWI), which offers a composite evaluation of ventilatory mechanics. This study aimed to compare these indices in Type 1 and Type 2 respiratory failure to examine their feasibility in assessing the likelihood of successful extubation. Methods The present cross-sectional study involved 35 participants (23 with Type 1 respiratory failure and 12 with Type 2 respiratory failure) successfully weaned from mechanical ventilation in the Emergency Department of a tertiary care hospital between 2022 and 2024. RSBI, VD/VT, IWI, and arterial blood gas values were evaluated. Data were analyzed descriptively and statistically, with statistical significance determined at p < 0.05. Results: Type 2 respiratory failure patients had a higher VD/VT ratio (0.37±0.04 vs. 0.29±0.13, p = 0.046) and a lower PaO₂/FiO₂ ratio (169±49.6 vs. 244±95.6, p = 0.017) than Type 1 patients. RSBI values did not differ significantly between the groups (p = 1.00). IWI values showed a trend toward lower scores in Type 2 patients, reflecting reduced weaning readiness, although the difference was not statistically significant. These results demonstrate that patients with hypercapnia have more significant impairments in gas exchange. Conclusion: RSBI was found to be less discriminative in identifying weaning failure, whereas VD/VT proved to be a more reliable predictor in hypercapnic respiratory failure. Additionally, IWI may serve as a useful complementary tool to improve weaning accuracy by integrating multiple physiological parameters into a single predictive measure.