OBJECTIVES: This study aimed to investigate the ability of the biomarkers to predict the surgery treatment and mortality in patients above 18 years of age who were hospitalized with the diagnosis of bowel obstruction from the emergency department. METHODS: This is a 2-year retrospective study. The patients' demographic data, laboratory parameters on admission to emergency department, treatment modalities, and the length of hospital stay were recorded. Patients were divided into two groups: conservative and surgical treatment. Statistical analysis was performed to investigate the value of biomarkers in predicting mortality and the need for surgery. Data were analyzed using IBM SPSS version 22. RESULTS: A total of 179 patients were included in this study. Of these, 105 (58.7%) patients were treated conservative and 74 (41.3%) were treated operatively. The elevated procalcitonin (PCT) level, C-reactive protein, blood urea nitrogen-to-albumin ratio, and lactate-to-albumin ratio were significantly correlated with surgical treatment, length of hospital stay, and mortality. procalcitonin threshold value of 0.13 ng/mL was able to predict the need for surgical treatment, with a sensitivity of 79% and a specificity of 70.3%. Procalcitonin threshold value of 0.65 ng/mL was able to predict the mortality rate of the patients, with a sensitivity of 92.9% and a specificity of 78.1%. CONCLUSIONS: Biomarkers, especially procalcitonin, may be useful in bowel obstruction treatment management and may predict mortality.

The aim of the study is to determine the usefulness of base excess (BE) and creatine kinase (CK) in predicting the extent of damage to the extremities, the need for hemodialysis, and the likelihood of mortality in crush injuries. Our study included patients who were affected by the earthquakes that occurred in Kahramanmaras/Turkey on February 6, 2023 and were diagnosed with crush injuries. The study was a retrospective observational study. We used chi-square test, independent sample t test, analysis of variance (ANOVA) to examine whether CK and BE values can be used to predict damage to the extremities, hemodialysis requirement, and mortality. A total of 299 patients were included in the study. A statistically significant relationship was found between BE and extremity damage, hemodialysis requirement, and mortality (P < .005). A statistically significant difference was also seen in terms of extremity damage and hemodialysis requirement with CK (P < .001), while there was no statistically significant difference seen in mortality (P = .204). BE may serve as a predictive biomarker for the development of extremities damage, hemodialysis requirement, and mortality. CK is not predictive of mortality.

Ectopic pregnancy (EP) may cause significant morbidity and mortality. In this study, we aimed to evaluate the demographic characteristics, presence of risk factors and diagnostic parameters of the patient with EP and predicting parameters for ruptured EP. Patients who presented to emergency department (ED) and diagnosed as EP within one year were included to the study. The demographic characteristics, β-human chorionic gonadotropin (β-HCG) levels, transvaginal ultrasonography (TVUSG) findings, treatment protocols, pathology reports and hemoglobin levels at the time of admission to ED were obtained from patient files and hospital automation system and statistical analysis was performed. Total 35 patients were included to the study. The mean age of the patients was 30 ± 5.6 years. Among the patients, 46% had a history of caesarean section (C-section). The complaints of the patients at presentation, their age, gestational week and the β-HCG levels were found to be inefficient in predicting ruptured EPs. TVUSG was found statistically significant in terms of demonstrating ruptures in EP. The ratio of salpingectomies was observed to be higher in the surgical treatment of ruptured EPs. C-section was most frequently seen with EP. There is no absolute diagnostic parameter for predicting ruptured EPs and TVUSG may be a clue for diagnosis. The final diagnosis is made through surgery.

Some of the professions that require the knowledge and the ability to perform cardiopulmonary resuscitation (CPR) include physicians, nurses, paramedics, and firefighters. While firefighters are expected to meet certain criteria for body mass index (BMI), height, and weight to be recruited, medical professionals are not expected to meet such criteria. However, some studies have demonstrated that anthropometric variables affect the quality of CPR. The aim of our study was to investigate the effect of sex, age, BMI, and smoking habits in CPR practitioners on the quality of CPR. This study was planned as a prospective study. It was conducted with 104 nurses in the emergency department of a tertiary hospital. Participants were randomly assigned to groups of 2 members. Each of the 2 members in the group took turns to perform CPR for 2 minutes. Participants’ performance of CPR was recorded using the TrueCPR device. Of the 70 participants who were performed suboptimal CPR, 40 were in the nonsmoking group. Furthermore, 34 participants who were found to perform optimal CPR had a mean BMI of 23.6 (21.2–26.0) kg/m². Height, weight, and BMI values were found to have statistical significance in optimal CPR. According to the study, low BMI is associated with suboptimal CPR.

This study aimed to determine whether the D-dimer/high-sensitivity troponin I (hs-TnI) ratio is useful in the differential diagnosis of acute pulmonary embolism (APE) and/or non-ST-elevation myocardial infarction (NSTEMI) in patients who presented to the emergency department with chest pain. The study included 219 patients with APE and 385 patients with NSTEMI over the age of 18 who presented to the emergency department with chest pain and were diagnosed with either APE or NSTEMI. Using statistical analysis, D-dimer, hs-TnI, creatine kinase myocardial band (CK-MB) levels, D-dimer/CK-MB, and D-dimer/hs-TnI ratios were compared in patients with APE and NSTEMI. The D-dimer/hs-TnI ratio in patients with APE was found to be considerably greater than in patients with NSTEMI. Similarly, the D-dimer/CK-MB levels in patients with APE were significantly higher than in individuals with NSTEMI. Patients with APE had higher D-dimer levels, while those with NSTEMI had higher hs-TnI levels. The D-dimer/hs-TnI ratio can be useful for emergency clinicians because it is affordable, quickly calculated, and easily accessible.

Background: Physical examination and computed tomography angiography (CTA) are used for diagnosing arterial injury in extremity trauma. In recent years, CTA has been overused to obtain more objective data. Our study aimed to investigate the effect of using CTA for the management of patients with extremity penetrating injuries, specifically in cases where vascular injury was not detected during initial examination.Methods: This retrospective study included patients with penetrating trauma who underwent CTA of the extremities. The demographic data, mechanism of injury, the side of injury, initial vascular exam (normal, soft signs, and hard signs), radiological results, and any orthopedic and vascular intervention performed were recorded. The χ² test was used for independent variables. A significance level of p < 0.05 was used. We compared the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) for physical exam and CTA for identifying arterial injury requiring intervention.Results: Of the 252 patients included in the study, 29 (21.5%) had abnormal vascular physical examination while 26 (10.3%) had an abnormal CTA. The NPV of the hard sign for identifying vascular injury was 95.4%, while the sensitivity was 57.7%, specificity was 100%, and PPV was 100%. The NPV of routine physical examination to determine the requirement for vascular intervention was 100%. The sensitivity and PPV of the soft sign in determining the need for vascular intervention were 65.4% and 77.3%, respectively.Conclusion: Vascular injury was present in all cases that had positive hard signs. CTA imaging and vascular intervention are not necessary in patients who exhibit no hard and/or soft indicators during a thorough physical examination.