Erroneous and delayed triage in an increasingly crowded emergency department (ED). ChatGPT is an artificial intelligence model developed by OpenAI^® and is being trained for use in natural language processing tasks. Our study aims to determine the accuracy of patient triage using ChatGPT according to the emergency severity index (ESI) for triage in EDs. In our cross-sectional study, 18 years and over patients who consecutively presented to our ED within 24 h were included. Age, gender, admission method, chief complaint, state of consciousness, and comorbidities were recorded on the case form, and the vital signs were detected at the triage desk. A five-member expert committee (EC) was formed from the fourth-year resident physicians. The investigators converted real-time patient information into a standardized case format. The urgency status of the patients was evaluated simultaneously by EC and ChatGPT according to ESI criteria. The median value of the EC decision was accepted as the gold standard. There was a statistically significant moderate agreement between EC and ChatGPT assessments regarding urgency status (Cohen’s Kappa = 0.659; P < 0.001). The accuracy between these two assessments was calculated as 76.6%. There was a high degree of agreement between EC and ChatGPT for the prediction of ESI-1 and 2, indicating high acuity (Cohen’s Kappa = 0.828). The diagnostic specificity, NPV, and accuracy of ChatGPT were determined as 95.63, 98.17 and 94.90%, respectively, for ESI high acuity categories. Our study shows that ChatGPT can successfully differentiate patients with high urgency. The findings are promising for integrating artificial intelligence-based applications such as ChatGPT into triage processes in EDs.

BACKGROUND Electrical injuries, ranging from minor skin burns to life-threatening conditions, are significant public health problems. These types of injuries are mostly accidental and affect individuals of all ages. This retrospective study evaluated the factors associated with hospitalization and 30-day mortality in 327 patients admitted to an emergency department (ED) in Turkey with electrical injuries between March 2019 and December 2023. MATERIAL AND METHODS Designed as a retrospective observational clinical study, patients with international classification disease (ICD) diagnosis codes W86 or W87 who were admitted to the ED Between March 01, 2019 and December 01, 2023 were included in the study. Patients' age, gender, type of electrical exposure, entry area, exit area, hospitalization, mortality rate, and length of stay (LOS) were recorded. RESULTS Most patients were male (74.6%), and the median age was 24 years. LVI (low-voltage injury) was 76.8% more common and the upper extremity was the most typical electrical entry area (72.5%). Median length of stay was <1 day, and HVI (high-voltage injury) was associated with longer stays (p<0.001). Patients with normal ECGs were predominantly exposed to low voltage and were more likely to be discharged (p<0.001). The 30-day mortality rate was 1.5% (n=5). According to logistic regression analysis, increasing age, ECG changes, HVI, LDH, and myoglobin increase were the factors affecting hospitalization (Negelkerle R²=0.568). CONCLUSIONS Age, ECG changes, YVI and LDH, and myoglobin increase were important factors affecting patient hospitalization.

Background: Helicopter ambulances (HAs) are a significant component of pre-hospital emergency medical services. This study presents a report on the demographic and clinical factors associated with transport to the emergency department (ED) by HA of 161 patients to a single center in Turkey. Material/Methods: Demographic data, diagnoses in arriving center's ED, transferred distance, and outcomes of 161 patients trans-ferred by HAs between March 01, 2019 and May 31, 2021 were retrospectively evaluated. Mortality rates of the cases were compared both with age and according to the distance traveled within the diagnostic groups. Results: There were 134 patients (83.2%) with internal diseases, and cardiovascular diseases were the leading cause (68 patients, 41.6%); 27 patients (16.7%) were transferred due to trauma. The mean distance traveled with HAs was 167.1 km (range, 47.0-1316.0) and the median transfer time was 50 min. The most common form of hos-pitalization after ED arrival was intensive care hospitalization (n=78, 48.4%). Mortality increased as the trans-fer distance increased in elderly patients, as well as those with a cardiac or trauma-related diagnosis (P=0.015, P=0.044, P=0.028, respectively). Conclusions: Most patients transferred by HA had severe disease. ED physicians dealing with patient transfer by HAs should be prepared for severe cases, both in the HA and in the ED. HAs may be preferred when making the transfer decision for elderly patients, trauma patients, and those with cardiac disease.

Background: The main causes of accidental trauma in children include road traffic accidents (RTAs) and falling from height (FFH). Rapid and accurate assessment of severity of injury is required to guide effective management. This retrospective study aimed to compare the Glasgow Coma Score (GCS), Pediatric Trauma Score (PTS), and Injury Severity Score (ISS) and outcomes for 118 pediatric trauma patients at a single Emergency Department (ED) in Turkey. Material/Methods: Patients admitted to Ankara City Hospital due to high-energy trauma between November 1, 2019 and April 30, 2020 were analyzed retrospectively. Data for 118 patients with trauma by major mechanisms, aged 0-17, were collected. Demographic characteristics, trauma -related characteristics, outcomes, and GCS, PTS, and ISS values were compared. It was examined whether there was a relationship between trauma severity and prognosis. In this context, trauma severity was defined by these scores. Results: Of the 118 admitted patients, 66 (55.9%) were discharged from the ED, 33 (28%) were transferred to the intensive care unit (ICU), and 19 (16.1%) were admitted to non -ICU departments in the hospital. With hospitalization, patients with thoracic trauma ( P <0.001; OR 11.1; 95% CI 3.0-40) and patients with abdominal trauma ( P =0.003; OR 4.0; 95% CI 1.5-10.8) were discharged significantly less frequently than patients with other types of trauma. Patients with low ISS ( P <0.001) and high PTS ( P <0.001) were discharged more often. The relationship between diagnosis and hospitalization was significant ( P <0.001). Conclusions: RTA and FFH are the leading trauma mechanisms in children. Boys experience more trauma. ISS and PTS provide accurate predictions of severe and poor prognosis in pediatric trauma cases.

BACKGROUND Ischemic stroke (IS) is a major cause of mortality and disability worldwide. Rapid and accurate diagnosis in the emergency department (ED) is crucial for improving outcomes. Neurogranin (Ng), a postsynaptic protein involved in synaptic plasticity, and Nardilysin (NRDC), a metallopeptidase with neuronal functions, have been linked to various neurological disorders. This study examines their potential diagnostic and prognostic value in IS. MATERIAL AND METHODS This prospective case-control study was carried out in a high-volume ED between June and October 2023. A total of 44 IS patients and 44 healthy controls, matched for age and sex, were included. Serum levels of Ng and NRDC were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analyses involved receiver operating characteristic (ROC) analysis to assess diagnostic value and comparisons of biochemical parameters between groups. RESULTS Ng levels were significantly higher in IS patients compared to controls (281.12±32.12 pg/mL vs 265.71±24.54 pg/mL, P=0.01), with moderate diagnostic accuracy (area under curve=0.624). Elevated Ng levels were associated with intensive care unit admission (311.50±46.13 pg/mL, P=0.023). NRDC levels showed no significant differences between groups or clinical outcomes. Biochemical parameters, including elevated urea and creatinine and reduced hemoglobin levels, showed the systemic impacts of IS. CONCLUSIONS Ng may have a limited role as a biomarker in IS diagnosis, while its potential prognostic value requires further validation. NRDC did not show significant utility in this study. Larger studies incorporating additional biomarkers are needed to determine whether Ng can provide clinical insights into IS diagnosis and prognosis.

Most elderly people live in low- and middle-income countries and are required to continue working. With the increasing number of elderly individuals in the workforce, occupational accidents among the elderly are predicted to remain a significant patient group for emergency departments. This study aimed to examine the descriptive characteristics of elderly individuals admitted to a tertiary-care emergency department due to occupational accidents and to identify factors that could predict their prognosis. Patients aged 65 years and older who presented to the emergency department due to an occupational accident between June 1, 2019, and June 30, 2023, were retrospectively reviewed. Data on demographic characteristics, trauma-related details, injury severity scores, ED and hospital stay durations, and mortality rates were analyzed and compared. In total, 92 elderly patients with occupational accidents were evaluated. The most common trauma mechanism was lacerations (n = 34, 37%), and the upper extremities were the most frequently affected body parts (n = 39, 42.4%). Patients with thoracic trauma, injuries from falls from heights, and higher injury severity scores had significantly longer emergency department and hospital stays (p = 0.045, p = 0.003, and p < 0.001, respectively). Occupational accidents in elderly individuals most commonly result in upper extremity injuries, with lacerations being the predominant trauma mechanism. Among elderly patients with occupational accidents, those with thoracic trauma due to falls from heights and those with high injury severity scores are associated with worse prognoses.