Background/aim: To describe seasonal variations in epidemiology, management, and short-term outcomes of patients in Europe presenting to an emergency department (ED) with a main complaint of dyspnea. Materials and methods: An observational prospective cohort study was performed in 66 European EDs which included consecutive patients presenting to EDs with dyspnea as the main complaint during 3 72-h study periods. Data were collected on demographics, comorbidities, chronic treatment, prehospital treatment, mode of arrival of patient to ED, clinical signs at admission, treatment in the ED, ED diagnosis, discharge from El), and in-hospital outcome. Results: The study included 2524 patients with a median age of 69 (53-80) years old. Of the patients presented, 991 (39.3%) were in autumn, 849 (33.6%) were in spring, and 48 (27.1%) were in winter. The winter population was significantly older (P < 0.001) and had a lower rate of ambulance arrival to ED (P < 0.001). In the winter period, there was a higher rate for lower respiratory tract infection (35.1%), and patients were more hypertensive, more hypoxic, and more hyper/hypothermic compared to other seasons. The ED mortality was about 1% and, in hospital, mortality for admitted patients was 7.4%. Conclusion: The analytic method and the outcome of this study may help to guide the allocation of ED resources more efficiently and to recommend seasonal ED management protocols based on the seasonal trend of dyspneic patients.

During the Eid al-Adha ("Sacrifice Feast") religious holiday in Muslim communities animal sacrifices are made over a period of 3 days every year. The aim of this study was to determine the type of sacrifice-related injuries, the characteristics of patients, treatments for injuries, and relationships between these factors to determine precautions that could be taken to avoid or mitigate sacrifice-related injuries. Retrospective study of medical records. Emergency units at two hospitals from 2010 to 2013. Patients admitted for treatment for injuries associated with sacrificial cutting during the four annual sacrifice feasts were classified as professional butchers, apprentice butchers, and third persons who were neither professional butchers nor apprentices. Injuries associated with animal sacrifice. Of 592 patients, 22 (3.7%) were professional butchers, 149 (25.2%) apprentice butchers, and 421 (71.1%) third persons. Significant relationships were found between the profession of the injured person and the injury and subsequent treatment (P < .05). To prevent and minimize the injuries associated with sacrificial cutting, there should be an area designated for sacrificing animals. Moreover, sacrifices should be performed by professionals in possession of a sacrificial cutting certificate. If owners of sacrificial animals insist on slaughtering animals, they should be trained by professional butchers who have a teaching certificate. To deal with an increasing number of such injuries during the sacrifice feast, hospital emergency units need to be adequately resourced with adequate equipment and staff. Regional and local data could not be assessed completely. Patients who presented on the 4th day were not included in the study.

Amaç: Bu çalışmada acil serviste kritik geriatrik hastaları belirlemede skorlama sistemlerinin güvenilirliğini karşılaştırmayı amaçlanmıştır. Gereç ve Yöntem: Bu prospektif çalışmaya 15 Ekim 2014-15 Kasım 2014 tarihleri arasında acil servise başvuran 65 yaş üstü hastalar dahil edildi. Çalışmada APACHE II (Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi II) , REMS (Hızlı Acil Tıp Skoru), HOTEL (hipotansiyon, oksijen satürasyonu, düşük vücut sıcaklığı, EKG değişiklikleri ve bağımsız yaşam kaybı), VIEWS (Vital PAC Erken Uyarı Skoru) ve VIEWS-L (Vital PAC Laktat Seviyesi ile Erken Uyarı Skoru) değerlendirildi. Bulgular: Çalışmaya dahil edilen 244 hastadan sağ kalanların yaş ortalaması 75.69 ± 6.96 yıl, ölen vakaların yaş ortalaması 80.47 ± 6.63 yıl, 139’u (%57) kadındı. Çalışmaya alınan hastaların 30'u (%12,3) mortal sonuçlandı. Yoğun bakımda yatan hastaların risk puanları, servisten taburcu olan veya hospitalize edilenlere göre daha yüksekti. Mortalite grubundaki tüm risk skorları diğer hasta gruplarına göre anlamlı derecede yüksek bulundu. Sonuç: Çalışma, acil serviste geriatrik hastaların değerlendirilmesinde, mortaliteyi ön görebilmek ve kritik hastaları seçebilmek için risk skorlama sistemlerinin güvenle kullanılabileceğini göstermiştir. Purpose: The aim of this study was to compare the reliability of scoring methods in determining critical geriatric patients in the emergency department. Materials and Methods: This prospective study included patients aged over 65 who presented to the emergency department between 15 October 2014 and 15 November 2014. APACHE II (Acute Physiology and Chronic Health Evaluation II), REMS (Rapid Emergency Medicine Score), HOTEL (Hypotension, Oxygen saturation, low Temperature, ECG changes, and Loss of independence), VIEWS (Vital PAC Early Warning Score) and VIEWS-L (Vital PAC Early Warning Score with Lactate Level) were evaluated. Results: Of the 244 patients included in the study, the mean age of survivors was 75.69 ± 6.96 years, and the mean age of the mortal cases was 80.47 ± 6.63 years, 139 (57%) women. It was found that 30 (12.3%) of the patients included in the study died. The risk scores of the patients hospitalized in the intensive care unit were higher than those who were discharged or hospitalized. All risk scores in the mortality group were found to be significantly higher than the other patient groups. Conclusion: The study showed that risk scoring systems can be used safely in the evaluation of geriatric patients in the emergency department, to predict mortality and to select critically ill patients.

Background/Aims: Our study aimed to assess the abilities of emergency medicine, general surgery, and plastic surgery resident doctors in diagnosing, treating, and managing burn patients. Methods: We conducted a survey study between 04.05.2015 and 04.08.2015 at university hospitals and training and research hospitals in Ankara. We collected information on the age, gender, experience, and hospital of the doctors, as well as their training and approaches to treating burn cases. We evaluated their knowledge in various areas, including clinical approaches to 2nd and 3rd-degree burn cases, escharotomy localizations, intubation indications, bulla treatment, referral and hospitalization indications, identification of inhalation burns, and fluid resuscitation. Results: The average age of the participants was 29.3±2.4 years, and 65.7% were male. We found that doctors who had received advanced burn life support training had better approaches to burn cases (p

Aims: To investigate whether prolonged emergency department length of stay is associated with increased mortality and altered clinical outcomes in critically ill COVID-19 patients requiring intensive care admission. This study aimed to evaluate the association between emergency department length of stay (ED-LOS) and mortality among COVID-19 patients admitted to intensive care units (ICUs) during the pandemic. Methods: This retrospective observational study included 258 adult patients who were admitted from the ED to COVID-19 ICUs between March 29, 2020, and January 17, 2021. Patients were categorized based on ED-LOS into two groups: “8 hours or less” and “more than 8 hours.” Demographic data, comorbidities, PCR test results, ED-LOS, ICU length of stay, and mortality outcomes were collected and analyzed using the Mann-Whitney U and Chi-square tests. Results: The median ED-LOS for all patients was 8 hours (IQR: 4–14). Among the 181 patients who died (70.2%), the median ED-LOS was 8 hours (IQR: 4–13.5), compared to 6 hours (IQR: 4–14) in survivors (p=0.216). The median time to mortality was 8 days in the ?8-hour group and 6 days in the >8-hour group (p=0.701). ICU length of stay was 10.5 days (IQR: 4–17) in the ?8-hour group and 9 days (IQR: 4–18) in the >8-hour group (p=0.627). No statistically significant association was found between ED-LOS and mortality or ICU stay duration. Conclusion: While no statistically significant relationship was observed between ED-LOS and mortality, patients who remained in the ED longer tended to experience earlier mortality and shorter ICU stays. These findings suggest that ED-LOS alone may not fully explain outcomes in critically ill COVID-19 patients and that system-level interventions such as early ED-based critical care and streamlined ICU transfers may play a vital role. Future research should explore these dynamics using multicenter, severity-adjusted designs.