Introduction. Health care workers have had a challenging task since the COVID‐19 outbreak. Prompt and effective predictors of clinical outcomes are crucial to recognize potentially critically ill patients and improve the management of COVID‐19 patients. The aim of this study was to identify potential predictors of clinical outcomes in critically ill COVID‐19 patients. Methods. The study was designed as a retrospective cohort study, which included 318 patients treated from June 2020 to January 2021 in the Intensive Care Unit (ICU) of the Clinical Hospital Center “Bezanijska Kosa” in Belgrade, Serbia. The verified diagnosis of COVID‐19 disease, patients over 18 years of age, and the hospitalization in ICU were the criteria for inclusion in the study. The optimal cutoff value of D‐dimer, CRP, IL‐6, and PCT for predicting hospital mortality was determined using the ROC curve, while the Kaplan‐Meier method and log‐rank test were used to assess survival. Results. The study included 318 patients: 219 (68.9%) were male and 99 (31.1%) female. The median age of patients was 69 (60‐77) years. During the treatment, 195 (61.3%) patients died, thereof 130 male (66.7%) and 65 female (33.3%). 123 (38.7%) patients were discharged from hospital treatment. The cutoff value of IL‐6 for in‐hospital death prediction was 74.98 pg/mL (Sn 69.7%, Sp 62.7%); cutoff value of CRP was 81 mg/L (Sn 60.7%, Sp 60%); cutoff value of procalcitonin was 0.56 ng/mL (Sn 81.1%, Sp 76%); and cutoff value of D‐dimer was 760 ng/mL FEU (Sn 63.4%, Sp 57.1%). IL‐6 ≥ 74.98 pg/mL, CRP ≥ 81 mg/L, PCT ≥ 0.56 ng/mL, and D‐dimer ≥ 760 ng/mL were statistically significant predictors of in‐hospital mortality. Conclusion. IL‐6 ≥ 74.98 pg/mL, CRP values ≥ 81 mg/L, procalcitonin ≥ 0.56 ng/mL, and D‐dimer ≥ 760 ng/mL could effectively predict in‐hospital mortality in COVID‐19 patients.

Background: Optimal energy and protein delivery during the early phase of severe trauma remains unclear. Observational studies frequently contradict the findings of randomized controlled trials, raising concerns about confounding factors. The aim of this study is to assess nutritional adequacy and daily variability in the energy gaps and its impact on outcomes using innovative statistical methods. Methods: Prospective observational study enrolled severely injured patients in the ICU at the Level 1 trauma center between October 2023 to April 2025. To describe the evolution of calorie and protein deficits during the first 10-day ICU stay, we utilized a linear mixed-effects model to estimate each patient’s individual energy gap trajectory. Results: 286 patients were analyzed. Median APACHE II and ISS score was 16.0 (12.0–20.0) and 22.0 (18.0–27.0), respectively. Mortality rate was 35.3%. Patients received 68.3% of prescribed calories and 76.8% of proteins. Admission energy deficit, rate of caloric intake, and their interaction are associated with ICU mortality. Increased day-to-day energy variability was associated with longer duration of mechanical ventilation (HR = 0.55, 95% CI: 0.31–0.99; p = 0.047). Patients who achieved better caloric (HR = 0.68, 95% CI: 0.48–0.98, p = 0.036) and protein (HR = 0.29, 95% CI: 0.09–0.96, p = 0.043) nutrition had a lower hazard of developing nosocomial infection. Conclusions: This study supports the 2023 ESPEN guidelines, showing that achieving the recommended energy and protein intake during the early phase of severe trauma is linked to lower mortality rates, shorter mechanical ventilation time, and reduced risk of nosocomial infections.

It has been a year and a half since the fight against the COVID-19 pandemic started. In today's protocols for the treatment of COVID-19 and the prevention of its complications, corticosteroid therapy and anticoagulant therapy have a crucial part. The goal of this article is to show, based on available data, both the benefits and the disadvantages of corticosteroid and anticoagulant therapy in treating the infection caused by the Sars-CoV-2 virus. At the very onset of the pandemic, an increased frequency of thrombotic events negatively impacting the course and outcome of the disease, was registered. It has been observed that increased values of D-dimer in patients with COVID-19 do not correlate with the presence of venous thrombosis and are not reliable in the detection of deep vein thrombosis and pulmonary thromboembolism. According to the National Protocol for Treating COVID-19 (Version 12), anticoagulant therapy is recommended in hospitalized patients. Due to the risk of different side effects, such as bleeding and heparin-induced thrombocytopenia, a careful use of anticoagulant therapy is necessary, as well as close monitoring of its effects. With respect to corticosteroids, their efficacy in patients with moderate and severe clinical presentation of COVID-19, who are in need of oxygen support, was analyzed. Corticosteroids have proven efficient in decreasing mortality, decreasing the need for mechanical ventilation, decreasing the length of stay in intensive care units, as well as in shortening the length of hospital stay. Assessing the individual benefits and risks before introducing these drugs into the therapy of a patient with confirmed COVID-19 is of vital importance for achieving the desired effects of the therapy.

Introduction/research objective: COVID-19 coagulopathy is a disorder of the hemostatic system that occurs in critically ill patients infected with the SARS-CoV 2 virus and it increases the risk of mortality. The goal of the research is to evaluate changes in hemostatic parameters and determine their prognostic significance in patients with a severe form of the COVID-19 disease. Methods: The study was designed as a retrospective cohort study, which included 146 patients treated from June to September 2020 in the Intensive Care Unit (ICU) of the Clinical Hospital Center "Bežanijska Kosa" in Belgrade, diagnosed with COVID-19 pneumonia. Inclusion criteria were as follows: the age over 18 years, proven current SARSCoV2 infection, and admission to ICU. Results: 82 patients (56.2%) died during the treatment, while 64 (43.8%) were discharged. Significantly higher D-dimer values on admission to the ICU were recorded in subjects who died during treatment 888 (1226.5) ng/ml compared to persons who were discharged from treatment 666 (1207.3) ng/ml (p = 0.03). Differences were not demonstrated for INR, aPTT and fibrinogen. D-dimer values on admission to the ICU greater than or equal to 760ng/ml are a statistically significant predictor of death during hospitalization (p = 0.04). Conclusion: COVID coagulopathy is a complication that increases the mortality of people infected with the SARS-CoV2 virus. The main feature is a state of hypercoagulability, which is detected by elevated D-dimer values. D-dimer greater than or equal to 760 ng/ml on admission to the ICU may have prognostic significance for survival during hospitalization.

Introduction: Branchial cleft anomalies are considered to develop from the branchial apparatus that did not completely obliterate during the embryogenesis of the head and neck. These anomalies pose a significant challenge in terms of surgical management, particularly followed by misdiagnosis due to its rarity. The aim of this case report was to present the review of literature and treatment of a rare anomaly such as a second branchial cleft cyst with a particular focus on clinical as well as histopathological aspects. Case report: A 24-year-old woman was admitted to the otolaryngology department with a three-month history of painless right-sided neck swelling, following a previously resolved upper respiratory infection. The patient underwent complete excision of the cystic mass, with excellent cosmetic results and no signs of recurrence after a one-year follow-up. Conclusion: Therefore, surgery should always be the gold standard of treatment. In patients aged over 40 years, cystic metastasis from the occult head and neck primary carcinoma must be considered.

Introduction: Trauma represents one of the most significant problems in public healthcare worldwide. It is one of the leading causes of mortality, particularly among children and young adults, but with a significant majority of non-fatal injuries that result in lifelong disabilities and health consequences. Proper and timely identification of patients with a higher risk of mortality is crucial for better outcomes in patients who suffer from trauma. The aim of this study is to identify potential predictors of in-hospital mortality among patients who suffered trauma and are treated in the ICU (Intensive Care Unit). Methods: The retrospective cohort study was conducted in a trauma, 12-bed ICU at the University Emergency Centre, University Clinical Centre of Serbia, Belgrade. All consecutive patients with blunt trauma were admitted to the ICU between August 2021 and August 2022. The primary outcomes of interest were all-cause in-hospital mortality. A value of p < 0.05 was considered statistically significant. Results: GCS (Hazard ratio 0.924 95%CI 0.873-0.979), vasopressors (Hazard ratio 3.47 95%CI 1.373-8.787) and age (Hazard ratio 1.030 95%CI 1.014-1.047) can independently predict in-hospital mortality. Conclusion:This study suggests risk factors for unfavorable clinical outcomes after severe trauma. It may be essential to properly and promptly differentiate between individuals with lower prognoses, which can lead to prompt and more aggressive treatment of these patients and might decrease in-hospital mortality. Age, vasopressors and mechanical ventilation, in particular, may be helpful indicators of in-hospital mortality of traumatized patients treated in the ICU.