Upper gastrointestinal bleeding (UGIB) continues to be a major global health concern, contributing substantially to both morbidity and mortality. This highlights the need for efficient and reliable risk assessment methods, particularly in emergency care settings. The primary objective of this study was to create a new risk scoring system that is easier to apply, more practical in clinical workflows, and highly effective for evaluating patients presenting to the emergency department with UGIB. This retrospective observational study was conducted at a single center by analyzing records of patients aged 18 years and older who presented to the Emergency Medicine Department of Sakarya Training and Research Hospital with clinical signs and symptoms suggestive of upper gastrointestinal bleeding (UGIB) between January 2022 and June 2023. For analytical purposes, patients were categorized into six distinct subgroups. Those assigned to transfusion, intervention, intensive care unit (ICU), readmission, or mortality groups were collectively defined as high-risk patients. Based on the collected clinical data, a novel scoring system-referred to as the ABL score-was developed. The diagnostic performance of this new score in identifying high-risk patients and each outcome subgroup was then evaluated and compared to existing scoring tools: the Glasgow Blatchford Score (GBS), AIMS65, and the pre-endoscopic Rockall Score (Pre-RS). A total of 589 patients were included, with a median age of 67 years, with a male ratio of 66.2%. ABL score, which includes Age, systolic Blood pressure, Laboratory parameters (hemoglobin, BUN/creatinine ratio, and international normalized ratio/albümin) was found to be more effective in predicting high-risk groups compared to the GBS, AIMS65, and Pre-RS scores ([AUROC]: 0.86, 0.806, 0.71, and 0.704, respectively; p < 0.05). The ABL score also performed better in predicting transfusion and readmission subgroups. (AUROC: 0.886 and 0.719, respectively). The ABL scoring system demonstrated higher predictive performance than GBS, AIMS65, and Pre-RS, particularly in identifying high-risk patients, transfusion requirements, and the likelihood of readmission. However, confirmation of these findings requires validation through larger, prospective studies.

Objectives: Aging is associated with immunosenescence, which may alter the physiological response to trauma and influence long-term outcomes. This study aimed to compare clinical and laboratory parameters associated with in-hospital (iHM) and one-year mortality (OYM) between adult and geriatric patients with multisystem trauma and to explore laboratory findings consistent with immunosenescence in geriatric patients. Methods: In this retrospective study, 345 patients with multisystem trauma were categorized into adult (n = 255) and geriatric (n = 90) groups according to age. Clinical characteristics and laboratory parameters obtained at emergency department admission were analyzed in relation to iHM and OYM. Results: Although iHM did not differ significantly between groups (p = 0.764), OYM was significantly higher in the geriatric group (p < 0.001). In adults, iHM was associated with a higher Injury Severity Score (ISS), prolonged intensive care unit (ICU) stay, elevated white blood cell and monocyte counts, and hypoalbuminemia. OYM in adults was further associated with a higher ISS, longer hospital stays, and lower hemoglobin and hematocrit levels. In geriatric patients, iHM was associated with a higher ISS, male sex, high-energy trauma, elevated lymphocyte and creatinine levels, and lower hematological ratios. OYM in the geriatric group was additionally associated with advanced age, major surgical intervention, thrombocytopenia, elevated urea–creatinine levels, hypoalbuminemia, and lower hematological ratios. Conclusions: Despite comparable in-hospital mortality, geriatric patients with multisystem trauma demonstrated significantly higher one-year mortality. The reduced post-traumatic inflammatory response observed in geriatric patients may be indicative of underlying immunosenescence and diminished immune reserve, thus emphasizing the necessity for age-specific prognostic models in trauma care.

Background: This study aimed to compare the emergency department (ED) and intensive care unit (ICU) admission processes of the local population and individuals with migrant, refugee, or asylum status as well as to evaluate differences between the groups. Methods: This retrospective observational study was conducted by analyzing the data of 10,163 patients who presented to the Emergency Medicine Clinic of Sakarya Training and Research Hospital between 1 January 2022 and 1 January 2024, and were determined to require ICU care. Among these, 10,060 were from the local population and 103 were refugees. Key variables, such as patients’ demographic characteristics, comorbidities, ED processes, hospital admission, and referral statuses, were collected and analyzed. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0. Results: The mean age of refugee patients was 39.1 ± 26.5 years, and they were younger than the local population. No significant difference was observed between the two groups in terms of examination waiting times and time to the first consultation (p = 0.721 and p = 0.060, respectively). Refugees were more frequently admitted to the ICU at the study hospital than the local population (85.4% vs. 61.0%, p < 0.001). Refugee status remained independently associated with ICU admission at the study hospital after adjustment for age, sex, and major comorbidities (adjusted OR: 2.57, 95% CI: 1.47–4.50; p = 0.001). Conclusions: In this study, no significant differences were observed between refugees and the local population in examination waiting time, time to first consultation, or ED length of stay. Refugees were younger and had a higher rate of ICU admission at the study hospital. These findings may contribute to a better understanding of healthcare utilization patterns among refugees requiring intensive care in Türkiye.