Pub Date : 2023-09-07DOI: 10.4274/eajem.galenos.2023.63239
Neeraj Kumar
133 Copyright 2023 The Emergency Physicians Association of Turkey / Eurasian Journal of Emergency Medicine published by Galenos Publishing House. Licenced by Creative Commons Attribution-NonCommercial-NoDerivatives (CC BY-NC-ND) 4.0 International License. Cite this article as: Kumar N. xxx Eurasian J Emerg Med. Eurasian J Emerg Med. Eurasian J Emerg Med. 2023;22(3): 133-4. Ischemic and hemorrhagic strokes are two important components of strokes and globally these strokes are the leading cause of mortality and long-term disability (1). Acute ischemic strokes (AIS) have a greater incidence than hemorrhagic strokes and they present with sudden onset of acute neurological deterioration. The outcome of these stroke patients depends on early and prompt diagnosis at the time of admission and quick restoration of normal cerebral blood flow required (2). Globally more than 12.2 million new strokes each year and one in four people over age 25 will have a stroke in their lifetime. Over 62% of all incident strokes are ischaemic strokes (3).
版权所有2023土耳其急诊医师协会/欧亚急诊医学杂志，Galenos出版社出版。根据知识共享署名-非商业性-非衍生品(CC by - nc - nd) 4.0国际许可协议授权。引用本文为:Kumar N. xxx欧亚新兴医学杂志。欧亚新兴医学杂志。2023;22(3):133-4。缺血性和出血性中风是中风的两个重要组成部分，在全球范围内，这两种中风是导致死亡和长期残疾的主要原因(1)。急性缺血性中风(AIS)的发病率高于出血性中风，并表现为急性神经功能恶化的突然发作。这些脑卒中患者的预后取决于入院时的早期和及时诊断以及所需的正常脑血流的快速恢复(2)。全球每年有超过1220万例新发脑卒中，25岁以上人群中有四分之一的人将在其一生中发生脑卒中。超过62%的中风是缺血性中风(3)。
{"title":"Importance of Serum Biomarkers for Early Diagnosis of Acute Ischemic Stroke: What’s New","authors":"Neeraj Kumar","doi":"10.4274/eajem.galenos.2023.63239","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2023.63239","url":null,"abstract":"133 Copyright 2023 The Emergency Physicians Association of Turkey / Eurasian Journal of Emergency Medicine published by Galenos Publishing House. Licenced by Creative Commons Attribution-NonCommercial-NoDerivatives (CC BY-NC-ND) 4.0 International License. Cite this article as: Kumar N. xxx Eurasian J Emerg Med. Eurasian J Emerg Med. Eurasian J Emerg Med. 2023;22(3): 133-4. Ischemic and hemorrhagic strokes are two important components of strokes and globally these strokes are the leading cause of mortality and long-term disability (1). Acute ischemic strokes (AIS) have a greater incidence than hemorrhagic strokes and they present with sudden onset of acute neurological deterioration. The outcome of these stroke patients depends on early and prompt diagnosis at the time of admission and quick restoration of normal cerebral blood flow required (2). Globally more than 12.2 million new strokes each year and one in four people over age 25 will have a stroke in their lifetime. Over 62% of all incident strokes are ischaemic strokes (3).","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43677362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-07DOI: 10.4274/eajem.galenos.2023.04810
M. Cakir, Ö. Bilir, G. Ersunan
Aim: To evaluate the characteristics and accompanying comorbidities of patients aged 65 years and older who presented to the emergency department with head trauma and were evaluated as forensic cases. Materials and Methods: The study was conducted with a retrospective evaluation of 157 patients aged 65 years and over who were admitted to the emergency department and evaluated as forensic cases. Results: The most common cause of head trauma was a fall. Of the patients, 38.9% were hospitalized for follow-up, 14% were followed up in the intensive care unit (ICU), and 14% died. Falling from a height, the presence of accompanying thoracic trauma, and an increased number of requested consultations were statistically associated with hospitalization (p<0.001). There was a statistically significant relationship between mortality and the presence of falling from a height as the cause of trauma, accompanying pelvic trauma, hemorrhage on brain computed tomography, ICU follow-up requirement, and active partial thromboplastin time among the coagulation parameters (p<0.001). Conclusion: Trauma has become the most important socioeconomic problem due to its consequences, such as death and disability in elderly patients. Intracranial bleeding, the presence of accompanying conditions, increases mortality; therefore, a multidisciplinary approach is required in the emergency care of this patient.
{"title":"Forensic Head Trauma in Elderly Patients Accompanying Comorbidities","authors":"M. Cakir, Ö. Bilir, G. Ersunan","doi":"10.4274/eajem.galenos.2023.04810","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2023.04810","url":null,"abstract":"Aim: To evaluate the characteristics and accompanying comorbidities of patients aged 65 years and older who presented to the emergency department with head trauma and were evaluated as forensic cases. Materials and Methods: The study was conducted with a retrospective evaluation of 157 patients aged 65 years and over who were admitted to the emergency department and evaluated as forensic cases. Results: The most common cause of head trauma was a fall. Of the patients, 38.9% were hospitalized for follow-up, 14% were followed up in the intensive care unit (ICU), and 14% died. Falling from a height, the presence of accompanying thoracic trauma, and an increased number of requested consultations were statistically associated with hospitalization (p<0.001). There was a statistically significant relationship between mortality and the presence of falling from a height as the cause of trauma, accompanying pelvic trauma, hemorrhage on brain computed tomography, ICU follow-up requirement, and active partial thromboplastin time among the coagulation parameters (p<0.001). Conclusion: Trauma has become the most important socioeconomic problem due to its consequences, such as death and disability in elderly patients. Intracranial bleeding, the presence of accompanying conditions, increases mortality; therefore, a multidisciplinary approach is required in the emergency care of this patient.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42489270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-18DOI: 10.4274/eajem.galenos.2023.33340
Ş. Çelik, İ. Korkmaz
Aim: To evaluate the power of the systemic immune-inflammation index (SII) in the prediction of mortality in patients with Crimean-Congo hemorrhagic fever (CCHF) presenting at the emergency department (ED). Materials and Methods: The study included patients who presented at the ED between April 2020 and November 2022 and were hospitalized for treatment in the Infectious Diseases Department. The demographic data, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and SII were recorded. Categorical data were analyzed with the chi-square test and continuous data with the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was performed to determine the factors predicting the risk of mortality. Results: The SII value (p=0.010) and NLR (p<0.001) were determined to be significantly higher and the PLR (p=0.015) was significantly lower in CCHF patients who developed mortality compared to those who did not. ROC analysis showed the NLR and SII parameters to be significant in the prediction of mortality. Conclusion: SII at the time of presentation at the ED can be used for predicting the mortality in CCHF patients.
{"title":"The Prognostic Importance of the Systemic Immune-inflammation Index in Patients with Crimean-Congo Hemorrhagic Fever","authors":"Ş. Çelik, İ. Korkmaz","doi":"10.4274/eajem.galenos.2023.33340","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2023.33340","url":null,"abstract":"Aim: To evaluate the power of the systemic immune-inflammation index (SII) in the prediction of mortality in patients with Crimean-Congo hemorrhagic fever (CCHF) presenting at the emergency department (ED). Materials and Methods: The study included patients who presented at the ED between April 2020 and November 2022 and were hospitalized for treatment in the Infectious Diseases Department. The demographic data, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and SII were recorded. Categorical data were analyzed with the chi-square test and continuous data with the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was performed to determine the factors predicting the risk of mortality. Results: The SII value (p=0.010) and NLR (p<0.001) were determined to be significantly higher and the PLR (p=0.015) was significantly lower in CCHF patients who developed mortality compared to those who did not. ROC analysis showed the NLR and SII parameters to be significant in the prediction of mortality. Conclusion: SII at the time of presentation at the ED can be used for predicting the mortality in CCHF patients.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42588166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-18DOI: 10.4274/eajem.galenos.2023.54037
Miroslaw Dabkowski, Damian Świeczkowski, M. Pruc, B. Cander, M. Gül, N. Bragazzi, L. Szarpak
Aim: The aim of this systematic review and meta-analysis was to assess the influence of the Coronavirus disease-2019 (COVID-19) pandemic on the incidence, characteristics, and clinical consequences of out-of-hospital cardiac arrest (OHCA). Materials and Methods: We searched PubMed, Embase, Scopus, Web of Science, and Cochrane Library databases up to May 30, 2023 for studies containing comparative data of OHCA patients in COVID-19 and pre-pandemic periods. Results: A total of 35 articles concerning to 34 studies screening based on the inclusion criteria. COVID-19 was associated with higher incidence of OHCA at home compared with the pre-pandemic period (p<0.001), longer emergency medical services arrival time (p<0.001), longer on-scene time (p<0.001), as well as reduction of shockable rhythms (p=0.02). COVID-19 compared with the pre-pandemic period was associated with lower survival to hospital admission (11.2% vs. 19.3%; p<0.001). Survival to hospital discharge (SHD) was 4.8% vs. 12.9%, respectively (p<0.001), while SHD with a good neurological outcome also varied and amounted to 3.6% vs. 5.8%, respectively (p<0.001). Conclusion: COVID-19, compared with the pre-pandemic period, was characterized by a reduced rate of defibrillation rhythms during OHCA, as well as a worse prognosis in terms of both survival to hospital admission, SHD, and SHD good neurological outcome.
{"title":"Unraveling the Consequences of the COVID-19 Pandemic on Out-of-hospital Cardiac Arrest: A Systematic Review and Meta-analysis","authors":"Miroslaw Dabkowski, Damian Świeczkowski, M. Pruc, B. Cander, M. Gül, N. Bragazzi, L. Szarpak","doi":"10.4274/eajem.galenos.2023.54037","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2023.54037","url":null,"abstract":"Aim: The aim of this systematic review and meta-analysis was to assess the influence of the Coronavirus disease-2019 (COVID-19) pandemic on the incidence, characteristics, and clinical consequences of out-of-hospital cardiac arrest (OHCA). Materials and Methods: We searched PubMed, Embase, Scopus, Web of Science, and Cochrane Library databases up to May 30, 2023 for studies containing comparative data of OHCA patients in COVID-19 and pre-pandemic periods. Results: A total of 35 articles concerning to 34 studies screening based on the inclusion criteria. COVID-19 was associated with higher incidence of OHCA at home compared with the pre-pandemic period (p<0.001), longer emergency medical services arrival time (p<0.001), longer on-scene time (p<0.001), as well as reduction of shockable rhythms (p=0.02). COVID-19 compared with the pre-pandemic period was associated with lower survival to hospital admission (11.2% vs. 19.3%; p<0.001). Survival to hospital discharge (SHD) was 4.8% vs. 12.9%, respectively (p<0.001), while SHD with a good neurological outcome also varied and amounted to 3.6% vs. 5.8%, respectively (p<0.001). Conclusion: COVID-19, compared with the pre-pandemic period, was characterized by a reduced rate of defibrillation rhythms during OHCA, as well as a worse prognosis in terms of both survival to hospital admission, SHD, and SHD good neurological outcome.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46499344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-18DOI: 10.4274/eajem.galenos.2023.75875
Ş.sinem Özbay, H. Aydın, İ. Korkmaz, Y. Tekin, G. Tekin, Sefa Yurtbay, Ata Berkay Sargın, N. Hekim
Aim: Metabolic changes begin after the invasion of an infectious microorganism and continue to develop as a series of interrelated events. Arginine is important in infectious diseases due to lymphocyte proliferation, nitricoxide production by macrophages, and the use of polyamides in the immune response. In this study, we aimed to examine the possible causes and consequences of urea cycle amino acid metabolism changes by comparing plasma arginine and urea cycle amino acid levels in Coronavirus disease-2019 (COVID-19) patients. Materials and Methods: In this cross-sectional study, we evaluated the urea cycle and arginine metabolic changes and compared the plasma aminoacid levels of 35 COVID-19 patients and a healthy control group (n=35). The patient was diagnosed by reverse transcriptase-polymerase chain reaction of oropharyngeal-nasofaringeal swab specimens. For statistical analyzes, Mann-Whitney U and chi-square tests were used. Results: The aminoacid plasma levels of argininosuccinate (1.03 µmol/L, p=3.3x10 -3 ), arginine (53.64 µmol/L, p=1.1x10 -3 ), aspartic acid (3.83 µmol/L, p=5.5x10 -9 ), citrulline (27.79 µmol/L, p=3.3x10 -5 ), glutamine (489.6 µmol/L, p=9.0x10 -17 ), lysine (206.4 µmol/L, p=5.8x10 -8 ), ornithine (129.5 µmol/L, p=0.012), plasma levels and glutamine/glutamate (p=3.4x10 -11 ), arg/ornithine (p=0.033), asp/argininosuccinate (p=0.011) ratios were decreased in the COVID-19 patient group compared to the healthy group. Conclusion: Arginine is significant in endothelial control, the urea cycle, and immune activation. Arginine deficiency in COVID-19 patients
{"title":"Urea Cycle and Arginine Metabolic Changes in COVID-19 Patients","authors":"Ş.sinem Özbay, H. Aydın, İ. Korkmaz, Y. Tekin, G. Tekin, Sefa Yurtbay, Ata Berkay Sargın, N. Hekim","doi":"10.4274/eajem.galenos.2023.75875","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2023.75875","url":null,"abstract":"Aim: Metabolic changes begin after the invasion of an infectious microorganism and continue to develop as a series of interrelated events. Arginine is important in infectious diseases due to lymphocyte proliferation, nitricoxide production by macrophages, and the use of polyamides in the immune response. In this study, we aimed to examine the possible causes and consequences of urea cycle amino acid metabolism changes by comparing plasma arginine and urea cycle amino acid levels in Coronavirus disease-2019 (COVID-19) patients. Materials and Methods: In this cross-sectional study, we evaluated the urea cycle and arginine metabolic changes and compared the plasma aminoacid levels of 35 COVID-19 patients and a healthy control group (n=35). The patient was diagnosed by reverse transcriptase-polymerase chain reaction of oropharyngeal-nasofaringeal swab specimens. For statistical analyzes, Mann-Whitney U and chi-square tests were used. Results: The aminoacid plasma levels of argininosuccinate (1.03 µmol/L, p=3.3x10 -3 ), arginine (53.64 µmol/L, p=1.1x10 -3 ), aspartic acid (3.83 µmol/L, p=5.5x10 -9 ), citrulline (27.79 µmol/L, p=3.3x10 -5 ), glutamine (489.6 µmol/L, p=9.0x10 -17 ), lysine (206.4 µmol/L, p=5.8x10 -8 ), ornithine (129.5 µmol/L, p=0.012), plasma levels and glutamine/glutamate (p=3.4x10 -11 ), arg/ornithine (p=0.033), asp/argininosuccinate (p=0.011) ratios were decreased in the COVID-19 patient group compared to the healthy group. Conclusion: Arginine is significant in endothelial control, the urea cycle, and immune activation. Arginine deficiency in COVID-19 patients","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42539591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-15DOI: 10.4274/eajem.galenos.2023.37268
F. Çakmak, H. Çelik
Aim: Dizziness is one of the most common complaints in society and one of the most frequent reasons for referral to both emergency departments and outpatient neurology clinics. This study aimed to investigate the demographic characteristics and etiology of vertigo in patients who presented to the hospital with dizziness and were diagnosed with benign paroxysmal positional vertigo (BPPV). Materials and Methods: In this study, the data of patients who presented to a private secondary care hospital due to vertigo were retrospectively analyzed. Peripheral-central differentiation, medical history, and additional symptoms were examined and statistically compared between patients diagnosed with BPPV and those with generalized dizziness. Results: The study included 120 patients. Of the patients diagnosed with BPPV, 68.4% were female. Peripheral causes were detected in 76.6% (n=92) of the patients. Vertigo was the most common presenting symptom in 84.2% of the patients in the BPPV group. Eighteen (15.0%) patients with generalized dizziness and two (5.2%) with BPPV were hospitalized. The difference in the hospitalization rates of the two groups was statistically significant (p=0.003) Conclusion: BPPV is the most common etiology in most patients with dizziness. Therefore, knowing the general epidemiological and demographic characteristics of patients with dizziness is an important factor in the management of vertigo.
{"title":"Evaluation of Benign Paroxysmal Positional Vertigo in Patients Presenting to the Hospital with Dizziness: A Retrospective Study","authors":"F. Çakmak, H. Çelik","doi":"10.4274/eajem.galenos.2023.37268","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2023.37268","url":null,"abstract":"Aim: Dizziness is one of the most common complaints in society and one of the most frequent reasons for referral to both emergency departments and outpatient neurology clinics. This study aimed to investigate the demographic characteristics and etiology of vertigo in patients who presented to the hospital with dizziness and were diagnosed with benign paroxysmal positional vertigo (BPPV). Materials and Methods: In this study, the data of patients who presented to a private secondary care hospital due to vertigo were retrospectively analyzed. Peripheral-central differentiation, medical history, and additional symptoms were examined and statistically compared between patients diagnosed with BPPV and those with generalized dizziness. Results: The study included 120 patients. Of the patients diagnosed with BPPV, 68.4% were female. Peripheral causes were detected in 76.6% (n=92) of the patients. Vertigo was the most common presenting symptom in 84.2% of the patients in the BPPV group. Eighteen (15.0%) patients with generalized dizziness and two (5.2%) with BPPV were hospitalized. The difference in the hospitalization rates of the two groups was statistically significant (p=0.003) Conclusion: BPPV is the most common etiology in most patients with dizziness. Therefore, knowing the general epidemiological and demographic characteristics of patients with dizziness is an important factor in the management of vertigo.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41976450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-15DOI: 10.4274/eajem.galenos.2023.03780
E. Tekin, M. Kocak, M. Bayraktar, İbrahim Özlü, M. Çelik, Engin Kurt, Z. Halıcı
{"title":"Importance of Serum Andropin Levels in Ischemic Stroke: A Prospective Clinical Study","authors":"E. Tekin, M. Kocak, M. Bayraktar, İbrahim Özlü, M. Çelik, Engin Kurt, Z. Halıcı","doi":"10.4274/eajem.galenos.2023.03780","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2023.03780","url":null,"abstract":"","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46185609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-15DOI: 10.4274/eajem.galenos.2023.02347
Masoumeh Poureskandari, A. Ala, Elyar Sadeghi Hokmabadi, F. Rahmani, M. Amin, S. Vahdati
Aim: Many acute disorders, such as hypoglycemia, migraine, seizures, and others, can mirror stroke symptoms and are referred to as stroke mimics. The goal of this study was to determine the number of patients brought to the emergency department by the pre-hospital system with a possible stroke, as well as the accuracy of diagnosis and placement in the SAMA code to determine the genuine diagnosis of stroke and its separation. Materials and Methods: In this cross-sectional observational study, 150 patients who were referred to the emergency department for a period of 1 year with a complaint of acute stroke by the pre-hospital emergency department were examined for the accuracy of diagnosis and placement in the SAMA code. Results: There was a weak correlation between thrombolytic administration and diagnosis when looking at the probable correlation between the data. The major complaint of the patient and the final diagnosis at the emergency department have a considerable relationship; however, it is a weak relationship. kappa is equivalent to 0.043 when assessing the coefficient of agreement between the patient’s history and the final diagnosis given in the emergency department. Conclusion: Pre-hospital emergency staff have a terrible track record when it comes to assess patients who are at risk of a stroke. This team is not very excellent at identifying people who require thrombolytic therapy. Personnel changes have little bearing on personnel decisions or diagnosis, which are affected by disease. Patients with thrombolytics are evaluated, diagnosed, and treated regardless of their age or gender.
{"title":"Evaluation of Pre-hospital Stroke Diagnosis Agreement with Emergency Diagnosis","authors":"Masoumeh Poureskandari, A. Ala, Elyar Sadeghi Hokmabadi, F. Rahmani, M. Amin, S. Vahdati","doi":"10.4274/eajem.galenos.2023.02347","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2023.02347","url":null,"abstract":"Aim: Many acute disorders, such as hypoglycemia, migraine, seizures, and others, can mirror stroke symptoms and are referred to as stroke mimics. The goal of this study was to determine the number of patients brought to the emergency department by the pre-hospital system with a possible stroke, as well as the accuracy of diagnosis and placement in the SAMA code to determine the genuine diagnosis of stroke and its separation. Materials and Methods: In this cross-sectional observational study, 150 patients who were referred to the emergency department for a period of 1 year with a complaint of acute stroke by the pre-hospital emergency department were examined for the accuracy of diagnosis and placement in the SAMA code. Results: There was a weak correlation between thrombolytic administration and diagnosis when looking at the probable correlation between the data. The major complaint of the patient and the final diagnosis at the emergency department have a considerable relationship; however, it is a weak relationship. kappa is equivalent to 0.043 when assessing the coefficient of agreement between the patient’s history and the final diagnosis given in the emergency department. Conclusion: Pre-hospital emergency staff have a terrible track record when it comes to assess patients who are at risk of a stroke. This team is not very excellent at identifying people who require thrombolytic therapy. Personnel changes have little bearing on personnel decisions or diagnosis, which are affected by disease. Patients with thrombolytics are evaluated, diagnosed, and treated regardless of their age or gender.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42256797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-15DOI: 10.4274/eajem.galenos.2023.69320
Nur Aiza Mohamed Salleh, K. Poh, Hafizah Zainal Abidin, Teh Yong Hup Teh
Aim: The knowledge and understanding of medical futility and decisions about termination of resuscitation (TOR) for out-of-hospital cardiac arrest (OHCA) are highly heterogeneous and dependent on the practice and beliefs of the attending emergency physicians. The objective of this study was to determine current practice, knowledge and attitude among emergency medical practitioners regarding medical futility and termination of cardiopulmonary resuscitation (CPR) in OHCA patients in Hospital
{"title":"Questionnaire Survey Medical Futility and Termination of Resuscitation in Out-of-hospital-cardiac-arrest Patients Presenting to Emergency Department in Hospitals in Klang Valley","authors":"Nur Aiza Mohamed Salleh, K. Poh, Hafizah Zainal Abidin, Teh Yong Hup Teh","doi":"10.4274/eajem.galenos.2023.69320","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2023.69320","url":null,"abstract":"Aim: The knowledge and understanding of medical futility and decisions about termination of resuscitation (TOR) for out-of-hospital cardiac arrest (OHCA) are highly heterogeneous and dependent on the practice and beliefs of the attending emergency physicians. The objective of this study was to determine current practice, knowledge and attitude among emergency medical practitioners regarding medical futility and termination of cardiopulmonary resuscitation (CPR) in OHCA patients in Hospital","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46369879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-15DOI: 10.4274/eajem.galenos.2023.57615
Leyla Öztürk Sönmez, Nurmanbet Turaliev, M. Ayranci, Esma Erdemir Öztürk, A. Aydın
Aim: This study examined the etiological causes and their cost analysis in patients admitted and hospitalized with macroscopic hematuria (MH). Materials and Methods: Hemograms, urine, and biochemistry results of patients with MH, radiological images and pathology results, hospitalization need, hospitalization durations, and hematuria causes acquired following hospitalization, and the expenditures during this phase were registered for the patients. Laboratory values for the detected hematuria causes were compared and examined statistically. Results: Seventy-eight patients admitted to the emergency department with MH were evaluated. The most common underlying pathologies were bladder cancer (34.6%, n=27), prostate pathologies (24.3%, n=19), kidney stone (8.9%, n=7), urethral stone (7.7%, n=6), kidney cancer (7.7%, n=6), bladder stone (6.4%, n=5), urinary infection (6.4%, n=5), kidney laceration (2.6%, n=2) and arteriovenous malformation (1.3%, n=1) respectively. The mean invoice amount covering the management starting from admission with MH was 6647±10200 ₺ for each patient. In operated patients (n=54), hospitalization duration, catheterization duration, and invoice amount were found to be higher; in patients with malignancy (n=34) age, hospitalization duration, catheterization duration, and invoice amount were higher (p<0.05, all parameters). Conclusion: Among patients with MH, those with indications for surgery and malignancy have a greater impact on health expenditure. We can conclude that it will be beneficial for both the patient and the economy to start the diagnosis and treatment process before the onset of MH with prevention and early screening workups.
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