Background: During a major earthquake, escape attempts or collapsed buildings can result in injury, disability, and even death for victims. The aim of this study is to examine the demographic characteristics, clinical outcomes, and injuries of victims admitted to the emergency department within the first week after an earthquake.Methods: This is a retrospective observational study conducted on earthquake victims who were admitted to the emergency services of a tertiary medical faculty and a training and research hospital in the city of Diyarbakir, located in the Southeastern Anatolia Region of Turkey, from February 6 through February 12, 2023.Results: Of the eligible 662 earthquake victims, the mean age was 10.66 (SD = 4.78 [min 0, max 17]) in children, 36.87 (SD = 4.78 [min 18, max 63]) in adults, and 72.85 (SD = 5.83 [min 65, max 84]) in the elderly. Women constituted 52.8% of the victims, 19.7% were children, and 8.0% were elderly. Sixty-one percent (61.0%) of earthquake victims were admitted to emergency services in the first three days following the disaster; 37.7% of all victims were transferred from other affected cities to Diyarbakır. In all, 80.2% of the victims were admitted as survivors to the emergency services (36.8% were rescued under rubble, 40.1% with injuries while attempting to escape the earthquake, and 3.3% with nontraumatic reasons) and 19.8% were deceased under rubble. The majority of the 131 deceased victims were women (52.7%), 20.6% were children, and 7.6% were elderly. An estimated 38.3% of victims were hospitalized (20.9% in the ward and 17.4% in the intensive care unit [ICU]). For all age groups that survived under the rubble, the extremities were most injured (53.6% for children, 53.1% for adults, and 55.5% for the elderly). Of adult survivors, 26.6% needed only fluid therapy, renal replacement treatment (hemodialysis) was required 20.7%, and 11.8% required amputation. Of children survivors under the rubble, renal replacement treatment (hemodialysis) was required for only four, seven required amputation, and 12 needed only fluid resuscitation for crush injury. Of elderly survivors, two needed only fluid therapy, renal replacement treatment (hemodialysis) was required for two, and no amputation was required. Six patients survived under the rubble and died in the ICU.Conclusion: The definition of the demographic characteristics and clinical outcomes of earthquake patients is critical to the development of preparedness, response, and recovery policies for future disasters.

OBJECTIVES: There is no sufficient data to provide a clear picture of out-of-hospital cardiac arrest (OHCA) across Türkiye. This study is the first to present the prognostic outcomes of OHCA cases and the factors associated with these outcomes. MATERIALS AND METHODS: The study was conducted in a prospective, observational, multicenter design under the leadership of the Emergency Medicine Association of Turkey Resuscitation Study Group. OHCA cases aged 18 years and over who were admitted to 28 centers from Türkiye were included in the study. Survived event, return of spontaneous circulation (ROSC), survival to hospital discharge, and neurological outcome at discharge were investigated as primary outcomes. RESULTS: One thousand and three patients were included in the final analysis. 61.1% of the patients were male, and the average age was 67.0 ± 15.2. Cardiopulmonary resuscitation (CPR) was performed on 86.5% of the patients in the prehospital period by emergency medical service, and bystander CPR was performed on only 2.9% by nonhealth-care providers. As a result, the survived event rate was found to be 6.9%. The survival rate upon hospital discharge was 4.4%, with 2.7% of patients achieving a good neurological outcome upon discharge. In addition, the overall ROSC and sustained ROSC rates were 45.2% and 33.4%, respectively. In the multiple logistic regression analysis, male gender, initial shockable rhythm, a shorter prehospital duration of CPR, and the lack of CPR requirement in the emergency department were determined to be independent predictors for the survival to hospital discharge. CONCLUSION: Compared to global data, survival to hospital discharge and good neurological outcome rates appear to be lower in our study. We conclude that this result is related to low bystander CPR rates. Although not the focus of this study, inadequate postresuscitative care and intensive care support should also be discussed in this regard. It is obvious that this issue should be carefully addressed through political moves in the health and social fields.

Prognostic Value of HALP Score, PNI, and SII in Predicting 1-Year Mortality in Geriatric Femoral Fractures: A 5-Year Emergency Department Cohort Study - Article abstract #950481

Background: Hospitals, being establishments with varying functions and capacities, must have disaster plans that reduce vulnerability, ensure the continuity, and possibly increase the capacity of healthcare services; these measures are crucial for reducing mortality and facilitating the normalization of life after a disaster. In this study, the aim was to analyze the operational process of the disaster management plan at Dicle University Faculty of Medicine Hospital following the earthquake in Kahramanmaraş on 6 February 2023. Methods: This is a retrospective observational study. The study focused on determining the role of the hospital’s disaster plan in crisis situations, specifically examining the emergency service task distribution and management. Results: The study included patients aged 1 to 85 years (median 34, mean 36.9 ± 19.0), with 52.5% being female. The median injury severity score was 17 (mean 20.1 ± 19.2). Hospital admission was 65.7%, with nephrology and orthopedics being the most common departments. Higher injury severity scores were significantly associated with mortality (P < .05), and dialysis and surgery rates were significantly higher in deceased patients (P < .05). No significant differences were found in age, gender, or comorbidities between groups. Conclusion: The earthquake highlighted the importance of disaster preparedness in hospitals for effective patient care, collaboration among disciplines, and resource management. Detailed data on the hospital’s disaster plan and its operational process during the earthquake were provided to underscore its critical role in managing the crisis. Lessons learned will shape future disaster response protocols, stressing continual evaluation and improvement in healthcare disaster readiness.

Objective: Pulmonary embolism (PE) is a severe form of venous thromboembolism that poses a significant risk of morbidity and mortality by leading to acute respiratory and circulatory failure. Clinical scoring systems such as the simplified pulmonary embolism severity index (sPESI) and BOVA are widely used for prognostic prediction; however, their limitations highlight the need for novel biochemical markers. This study aims to evaluate the prognostic value of albumin/globulin (A/G) and lactate/globulin (L/G) ratios in predicting in‐hospital mortality and to investigate their relationship with existing scoring systems. Methods: In this retrospective study, 151 patients diagnosed with PE between January 2018 and December 2023 was analyzed. Data on demographics, comorbidities, vital signs, laboratory values, and outcomes were collected. Prognostic performance of A/G and L/G ratios was assessed through logistic regression and receiver operating characteristic (ROC) curve analysis. Results: The mean age was 60.5 ± 20.0 years, with 53.6% female patients. Deceased patients showed significantly higher age, hemodynamic instability, and altered mental status ( p < 0.05). Among scoring systems, the PESI score exhibited the highest prognostic accuracy (AUC = 0.910), followed by sPESI (AUC = 0.856) and BOVA (AUC = 0.845). Lower A/G ratios and higher L/G ratios were significantly associated with mortality ( p < 0.05). Conclusions: This study demonstrated that A/G and L/G ratios, along with sPESI and BOVA scores, are effective in predicting in‐hospital mortality in patients with pulmonary thromboembolism (PTE). A lower A/G ratio and a higher L/G ratio were associated with poor prognosis. Furthermore, the critical role of sPESI and BOVA scores in risk stratification was confirmed.

Aim: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterized by symptoms such as cough, dyspnea, and airflow limitation. The prevalence and health risks of COPD increase with age, making emergency interventions crucial for elderly patients. This study investigated the influence of bilirubin, lactate clearance, and albumin levels on mortality rates among elderly COPD patients in emergency settings to inform treatment strategies and improve clinical outcomes. Material and Methods: Elderly patients diagnosed with COPD were included in this retrospective cohort study. Data on demographics, clinical presentations, laboratory results, comorbidities, and outcomes were collected. Biochemical measurements were performed via biochemical analyses and arterial blood gas analyses. Results: Among the 139 patients studied, 89 (64%) were male with a mean age of 75 years. The mortality rate was 7.92%. No significant differences were observed in age, sex distribution, or comorbidities between deceased and surviving patients. Lactate clearance and bilirubin levels did not significantly affect mortality. However, albumin levels were notably lower in deceased patients (p