Objective: The HALP Score, which is a combination of hemoglobin, albumin, lymphocytes, and platelets, is a new index that shows nutritional status and systemic inflammation, provides information about patient prognosis. In this study, we aimed to investigate the relationship of HALP score, platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR) and with poor prognosis in intensive care patients. Material and Method: Our study was designed retrospectively on patients admitted from the emergency department (ED) to the intensive care unit (ICU). HALP scores, PLR and NLR values were calculated from the hemoglobin, albumin, lymphocyte, platelet and neutrophil values taken from the patients within 24 hours. One-week and three-month mortality were determined as poor outcomes. The relationship between results and poor outcomes was investigated. Results: A total of 250 patients were included in the study. The median age of the patients was 72.5%, and 43.6% (n=109) were female. When the variables between survivors and non-survivors were compared, NLR was found to be significantly higher in non-survivors. In addition, there was a significant difference between the two groups in terms of both one-week and three-month mortality regarding age, albumin, lymphocyte, and thrombocyte values. When we analyzed the diagnostic performances of HALP Score, NLR, and PLR for one-week and three-month mortality, only NLR showed significant diagnostic performance. The optimal cut-off point for NLR for both one-week and three-month mortality was 8.22 (for one-week mortality: AUC=0.598, p=0.007; for three-month mortality: AUC=0.592, p=0.011). Conclusion: It was observed that the HALP score was not an effective parameter in predicting prognosis in intensive care patients. It is thought that NLR has a significant relationship with one-week and three-month mortality and can be used as an effective parameter in the prediction of prognosis in intensive care patients.

Giriş: 3. Basamak Acil Servisimize ambulans ile getirilen hastaların demografik, klinik özelliklerini ve konsültasyon sürecini değerlendirmeyi amaçladık. Materyal ve metod: Acil servisin (AS) hasta kabulüne başladığı ilk günden itibaren bir yıllık süreçte ambulans ile başvuran erişkin hastaların ön tanıları, demografik özellikleri, klinik işlemleri ambulans sevk formlarından ve hastane bilgisayar sisteminden retrospektif olarak incelendi. Bulgular: 1 Şubat 2019 - 31 Ocak 2020 tarihleri arasındaki bir yıllık süreçte AS’e ambulans ile toplam 1582 erişkin hasta başvurmuş olup bu sayı aynı dönem içerisinde başvuruların %10,9’unu oluşturmaktadır. Başvuruların %56,5’i erkek olup, yaş ortalaması 61,8±20,2 yıl saptandı. Hastalar yaş gruplarına göre sınıflandırıldığında; %16,7’sinin 18-40 yaş arası, %30,9’unun 40-65 yaş arası, % 52,3’ünün ise 65 yaş üzeri olduğu saptanmıştır. En sık ambulans başvurusunun 12:00-18:00 saatlerinde (%36,7) ve çarşamba günü (%16,1) olduğu tespit edildi. Hastaların %12,7’si (n=201) adli vaka olarak değerlendirildi. Adli vakaların %75’ini erkek hastalar oluşturmaktadır (p

Background: HALP and modified-HALP (m-HALP) scores are novel indices combining albumin, hemoglobin, platelets, and lymphocytes, reflecting systemic inflammation and the physiological well-being of an individual. These scores provide information about a patient's prognosis. Objectives: In this study, we examined the prognostic effectiveness of HALP and m-HALP scores in patients with acute bronchiolitis for the first time. Method: This retrospective cross-sectional study, which was conducted at the Department of Pediatrics, Balikesir Ataturk City Hospital, Turkey, between January 2021 and January 2023, focused on children over 2 years of age diagnosed with acute bronchiolitis. Children who did not provide all necessary laboratory tests, were transferred to another center, or had comorbidities were excluded. HALP and m-HALP scores were calculated based on data obtained from patients’ blood samples, including albumin, hemoglobin, platelet, and lymphocyte counts. The primary outcome was defined by the necessity for admission to the intensive care unit (ICU). Secondary outcome measures included the need for intubation and the patients' clinical course. Results: A total of 344 pediatric patients were included in the study. The mean age of the patients was 13.17 ± 9.28 months (range: 1 - 24 months). Of the participants, 40.9% were male, and 43.31% required hospitalization in the ICU. Statistically significant differences were observed in albumin, lymphocyte count, NLR, PLR, HALP, and m-HALP values when comparing patients based on service and ICU hospitalization. HALP and m-HALP scores were effective parameters for differentiating the need for ICU admission, the need for intubation, and the severity of bronchiolitis in pediatric patients. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performance of HALP and m-HALP in predicting the need for ICU hospitalization. The optimal cut-off values were 50.54 and 7645023, respectively, and the area under the curve (AUC) values were 0.605 (95% CI: 0.544 - 0.667) and 0.631 (95% CI: 0.571 - 0.690), respectively. The sensitivity and specificity of the HALP score were 0.54 and 0.67, respectively, while the sensitivity and specificity of the m-HALP score were 0.57 and 0.69, respectively. Conclusions: HALP and m-HALP scores are effective parameters for predicting poor prognosis in patients with bronchiolitis and may be useful for clinicians in patient follow-up and prognosis prediction.

En tr Aim: Dyspnea can be a symptom of many diseases. Pulmonary thromboembolism (PTE) is the most important one of these conditions. It can occur together with COPD and PTE, and their symptoms may mask each other. Identify the relationship between d-dimer levels of patients diagnosed with COPD exacerbation; is to determine the cut-off value in case of connection. It is aimed to guide clinicians in their patient management according to the results. Materials and Methods: This study was conducted prospectively. Patient group was 49 patients presenting to the emergency department with exacerbation of COPD who have no comorbid disease such as malignancy, Diabetes Mellitus (DM), Chronic Hearth Failure (CHF); were over than 18 years old, non-pregnant; and with Glasgow Coma Scale (GCS) > 10 points and the control group consisted of 52 patients who presented to the emergency department with dyspnea who haven't got any diseases. Results: 65% of COPD patients are male. The most common comorbid disease was Hypertension (p <.05) in 7 patients (14,2%). Fibrinogen and d-dimer were higher in the patient group (p <.05). The D-dimer cut-off value in patients with COPD was 0.97 μg / ml (p<.05). Pulmonary thromboembolism was detected in 3 COPD attack patients (6%) (p <.05). During COPD exacerbation inflammatory markers such as C-reactive protein (CRP), D-dimer, fibrinogen increases. Conclusions: The incidence of PTE was significantly increased in patients with COPD exacerbation. PTE should be absolutely included in the differential diagnosis in patients presenting to the emergency department with dyspnea and necessary examinations should be performed for the retraction. Amaç: Dispne birçok hastalığın semptomu olabilir. Pulmoner tromboemboli (PTE) bu durumların en önemlilerinden birisidir. Kronik Obstruktiv Akciğer Hastalığı (KOAH) ve PTE birlikte bulunabilmekte ve semptomları birbirini maskeleyebilmektedir. KOAH alevlenme tanılı hastaların d-dimer seviyesi arasındaki ilişkinin tanımlanması ve bağlantı durumunda cut-off değeri belirlemektir. Klinisyenlere hasta yönetiminde yol gösterici olunabilmesi hedeflenmiştir. Gereç ve Yöntem: Bu çalışma prospektif olarak yapılmıştır. 18 yaşından büyük, Diyabetes mellitus (DM), Konjestif Kalp Yetmezliği (KKY), malignite gibi ek hastalığı bulunmayan, gebeliği olmayan, Glasgow Koma Skalası (GKS) > 10 olan KOAH alevlenme ile acil servise başvuran 49 kişilik hasta grubu ve herhangi bir hastalığı olmayıp ve dispne ile acil servise başvuran 52 kişilik kontrol grubu ile oluşturuldu. Bulgular: KOAH hastalarının %65'i erkekti. En sık eşlik eden ek hastalık; 7 kişide (%14,2) saptanan hipertansiyon oldu (p< .05). Fibrinojen ve d-dimer hasta grubunda daha yüksek bulunmuştur (p< .05). KOAH hastalarında d-dimer cut-off değeri 0,97 μg/ml olarak saptanmıştır (p< .05). KOAH atak ile başvuran 3 kişide (%6) pulmoner tromboemboli saptanmıştır (p< .05). KOAH alevlenmesi sırasında C-reaktif protein (CRP), D-dimer, fibrinojen gibi inflamatuar belirteçler artmaktadır. Sonuç: KOAH alevlenmesi olan hastalarda PTE insidansı önemli ölçüde artmıştır. Acil servise dispne ile başvuran hastalarda PTE mutlaka ayırıcı tanıya dahil edilmeli ve ekartasyon için gerekli işlemler yapılmalıdır.

Aim: Compare the emergency department (ED) use characteristics of old and new refugees and the local people and to investigate whether it brings a different financial burden on the economy of the country. Materials and Methods: Syrian, Afghan, and Turkish patients who presented to the emergency department between January 1, 2016, and December 31, 2019, were randomly assigned to groups of 1000 people. The data were analyzed retrospectively. Results: Syrian patients presented to the ED with simpler etiologies 1.573 times more (Triage 4-5) compared to Turkish patients (p=0.009). The rate of visits by females was higher in those with triage1-2-3 than those with triage 4-5 (p=0.001). There was no difference between during-working-hours or outside-working-hours visits of those with triage 1-2-3. The average per capita cost of Turkish patients was found to be 109.60±73.36 Turkish Liras (TL), while it was between 96.20±35.61 and 95.24±28.24 TL for Syrian and Afghan patients. No difference was found in terms of per capita costs between nationalities (p=0.766). Conclusion: Refugees should be trained about the health system after they are admitted to the country, health literacy training programs should be planned for individuals in society from a young age, primary healthcare services should be used more effectively.