Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES最新文献

{"title":"Epidemiology and injury characteristics of children with acute traumatic hand injuries undergoing surgery: a 10-year retrospective cohort study.","authors":"Serpil Savaş, Selman Hakkı Altuntaş, Fuat Uslusoy, Adnan Karaibrahimoğlu","doi":"10.14744/tjtes.2025.07892","DOIUrl":"10.14744/tjtes.2025.07892","url":null,"abstract":"<p><strong>Objectives: </strong>The epidemiology of acute hand injuries that require surgery in children is poorly defined. The purpose of this study was to outline the epidemiological and injury characteristics of surgically treated acute traumatic hand injuries in children and offer preventive recommendations.</p><p><strong>Methods: </strong>We performed a retrospective descriptive epidemiological study of surgically treated acute traumatic hand injuries observed between 2004 and 2024 in a tertiary university hospital. The analysis included patients under 18 years of age, and examined demographics, injury mechanisms, causes, injury characteristics, and severity using the Modified Hand Injury Severity Scale (MHISS).</p><p><strong>Results: </strong>Two hundred ninety-five patients were enrolled in the study. Injuries were most common among males and adolescents. The most frequent mechanism of acute hand injury was laceration (78.6%). Accidental falls with glass cups in toddlers and preschool children, street glass shards in schoolchildren, and punching glass and chainsaw injuries in adolescents were the most common causes of lacerations. The Modified Hand Injury Severity Score (MHISS) indicated that most hand injuries were moderate (35.9%). Complex injuries accounted for 39.7% of all cases, and 10.8% of patients required additional surgeries.</p><p><strong>Conclusions: </strong>The main cause of acute traumatic hand injuries requiring surgery in children is laceration due to glass, motorized and non-motorized farming equipment, cutting machines, knives, and various sharp objects. Raising parental awareness and educating the community can help to reduce the incidence of these injuries.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"729-738"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting one-year mortality in patients over 65 years of age undergoing surgery for hip fracture.","authors":"Zafer Güneş, Eralp Erdoğan, Kubilay Uğurcan Ceritoglu, Cem Nuri Aktekin","doi":"10.14744/tjtes.2025.69199","DOIUrl":"10.14744/tjtes.2025.69199","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, our objective was to investigate the factors that affect 1-year mortality in patients over 65 years of age who were hospitalized due to hip fracture.</p><p><strong>Methods: </strong>This retrospective cohort study is based on data from our clinical archives collected between January 2013 and December 2021. All consecutive patients over 65 years of age with hip fractyres admitted to our hospital were considered for inclusion in the study.</p><p><strong>Results: </strong>During the period from January 2013 to December 2021, 834 patients met the inclusion criteria. The one-year mortality rate was 33.5 % (279/834). The mean surgery time was 5.64 days in patients with 1-year mortality; and 4.50 days in patients who lived longer than one year (P = 0,001). The mean values of hemoglobin, creatinine, lymphocyte count, and albumin of patients in the one-year mortality group were 11.47 g/dL, 1.33 mg/dL, 1.10x103/μL and 3.42 g/L, respectively. The same values of those who survived for more than a year were 11.93 g/dL, 1.12 mg/dL, 1.35x103/μL and 3.68 g/L, respectively (P= 0.006, 0.002, 0.001 and 0,000, respectively).</p><p><strong>Conclusions: </strong>We found that older patient age, delayed surgery, low albumin level, low total lymphocyte count, and high creatinine levels at hospital admission are associated with increased mortality after hip fracture. Comorbidities, number of comorbidities, transfusions, and ICU requirements were not associated with increased mortality, unlike the literature.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"776-782"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracardiac shrapnel fragment after blast injury in a hemodynamically stable patient: a case report from Somalia.","authors":"Tuba Betul Umit","doi":"10.14744/tjtes.2025.92267","DOIUrl":"10.14744/tjtes.2025.92267","url":null,"abstract":"<p><p>In conflict-affected regions such as Somalia, injuries resulting from terror-related explosions impose a substantial public health burden. Shrapnel injuries are frequently encountered and often lead to multiple trauma, with penetrating thoracic injuries among the most clinically significant. Although rare, cardiac trauma presents considerable diagnostic and therapeutic challenges for emergency physicians and trauma surgeons. While surgical intervention is typically indicated in hemodynamically unstable patients, the optimal management for retained intracardiac foreign bodies (FBs) in stable patients remains an area of clinical uncertainty. The decision between surgical removal and conservative observation is influenced by several factors, including hemodynamic stability, the presence of cardiac complications, and the characteristics of the retained object. We present a case of a hemodynamically stable patient in Somalia with a retained intracardiac shrapnel fragment following a terror-related explosion. Imaging studies, particularly transthoracic echocardiography, revealed a foreign body within the pericardial space, without evidence of tamponade or myocardial injury. Given the stable clinical course and absence of acute cardiac pathology, a non-operative strategy with close clinical and echocardiographic monitoring was adopted. The patient remained complication-free and was successfully managed. This case underscores the feasibility of conservative treatment in selected hemodynamically stable patients with intracardiac FBs and highlights the necessity of an individualized, multidisciplinary clinical approach in complex trauma scenarios.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"819-821"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-earthquake delayed bowel perforations in multi-trauma patients: Insights from the 2023 Türkiye earthquakes.","authors":"Hilmi Anil Dincer, Mehmet Ruchan Karaca, Nezih Akkapulu","doi":"10.14744/tjtes.2025.03633","DOIUrl":"10.14744/tjtes.2025.03633","url":null,"abstract":"<p><p>Intestinal perforation may occur, albeit rarely, following blunt abdominal trauma. However, there is insufficient data in the literature regarding late-onset intestinal ischemia and perforation observed during hospitalization in patients rescued from under the rubble after earthquakes. The intestinal perforations that occurred in this patient group were defined as 'stress-related intestinal ischemia.' After the two earthquakes measuring 7.8 and 7.5 on the Moment Magnitude Scale that occurred in Türkiye on February 6, 2023, a total of 1261 patients were treated at our hospital. Among these patients, delayed intestinal perforation developed in three cases (0.23%) during their hospitalization for various reasons. Two of the patients had a history of hemodialysis due to acute kidney injury, while one patient had undergone continuous renal replacement therapy. No mesenteric injury was detected in any patient, and the median time between the earthquake and the development of intestinal perforation was 30 days. Two patients underwent small bowel resection and anastomosis, while the other patient underwent subtotal colectomy with end colostomy. The median length of stay in the general surgery ward following abdominal surgery was 12 days, and the median total hospital stay for treatment was 67 days. All patients were successfully discharged after completion of their postoperative treatment. In conclusion, delayed intestinal perforations may occur in multi-trauma patients after earthquakes, especially in those with risk factors such as hemodialysis, major surgeries, and prolonged hospitalizations. Stress-induced intestinal necrosis should be considered in the differential diagnosis of acute abdominal conditions that may develop during extended hospital stays.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"809-812"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of epigallocatechin gallate on ischemia-reperfusion injury: an experimental study in rats.","authors":"Yusuf Ergün, Yaşarcan Baykişi, Metin Kılınç, Ayşe Nur Mavigök, Nadire Eser, Furkan Toksözlü, Duygun Altıntaş Aykan","doi":"10.14744/tjtes.2025.52279","DOIUrl":"10.14744/tjtes.2025.52279","url":null,"abstract":"<p><strong>Background: </strong>Skeletal muscle ischemia-reperfusion injury (IRI) is a significant concern in various clinical settings. Oxidative stress and neutrophil infiltration play central roles in its pathophysiology. However, clinicians have very few therapeutic options for the prevention and treatment of IRI. The present study aimed to investigate the effects of epigallocatechin gallate (EGCG) on (i) skeletal muscle injury, (ii) oxidative stress, and (iii) markers related to neutrophil infiltration.</p><p><strong>Methods: </strong>This was an experimental study conducted on rats. The IRI model involved the application of an elastic rubber band for 4 + 2 hours (IRI group). In the sham control (SC) group, all procedures were identical except for the rubber band application. Saline (10 mL/kg, intraperitoneally) and EGCG (25 or 50 mg/kg, intraperitoneally) were administered 30 minutes before reperfusion (IRI-SF, IRI-25, and IRI-50 groups, respectively). Creatine phosphokinase (CPK) was the primary endpoint. Other parameters included lactate dehydrogenase (LDH), total oxidant status (TOS), total antioxidant status (TAS), myeloperoxidase (MPO), E-selectin, P-selectin, L-selectin, intercellular adhesion molecule-1 (ICAM-1), and various cytokines (interleukin-1 beta [IL-1β], IL-6, and tumor necrosis factor-alpha [TNF-α]), which were measured in serum or gastrocnemius muscle samples.</p><p><strong>Results: </strong>CPK, LDH, and TOS levels were higher in the IRI group compared to the SC group (p=0.001, p=0.0001, and p=0.005, respectively). Although not statistically significant, decreases in these parameters were observed in the IRI-50 group compared to the IRI group (p=0.628, p=0.167, and p=0.444, respectively). Regarding TAS, a noticeable decrease was observed in the IRI group compared to the SC group (p=0.054), which was significantly increased by treatment with 50 mg/kg EGCG (p=0.011). For the remaining parameters (except IL-6), there were no statistically significant increases in the IRI group compared to SC, nor decreases in the EGCG-treated groups compared to the IRI group.</p><p><strong>Conclusion: </strong>We propose that EGCG possesses antioxidant activity. However, any beneficial effect related to its interaction with neutrophil infiltration markers remains only suggestive.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"713-721"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma due to wounding crimes: Demographic analysis and forensic reporting.","authors":"Emre Gürkan Bulutluöz, Hüseyin Balandız, Sait Özsoy","doi":"10.14744/tjtes.2025.22724","DOIUrl":"10.14744/tjtes.2025.22724","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate traumatic injuries resulting from wounding crimes from a forensic medical perspective, determine the demographic characteristics of the victims, and characterize injury patterns.</p><p><strong>Methods: </strong>A retrospective review was conducted on 2,164 forensic reports prepared between January 1, 2023 and June 30, 2024 at the Department of Forensic Medicine, Gülhane Training and Research Hospital. Data including gender, age, marital status, educational level, type of assault, nature of the forensic traumatic event, traumatic injuries, affected body regions, and injury characteristics were analyzed using IBM SPSS Statistics 26.0. The results were evaluated statistically.</p><p><strong>Results: </strong>Of the victims, 72.8% were male and 27.2% female. Injuries occurred most frequently in the 21-30 age group (30.4%). A significant decrease in the incidence of injuries was observed with increasing education levels (p<0.05). The fact that 22.1% of victims were university graduates suggests that higher education may serve as a protective factor against victimization. The most common cause of trauma was assault (54.6%), followed by traffic accidents (35.9%). Injuries often involved multiple body regions (39.3%), with the head-neck region (30.6%) and upper extremities (13.4%) being most commonly affected. It was determined that 66.6% of the injuries were mild enough to be treated with simple medical interventions, while 6.9% were life-threatening. Traffic accidents were significantly associated with fractures and dislocations (23.6%). Additionally, facial injuries due to assaults occurred frequently and were statistically significant (68.6%; p<0.05).</p><p><strong>Conclusion: </strong>This study highlights the demographic distribution of assault-related crimes and the forensic implications of traumatic injuries, emphasizing the importance of preventive measures and the necessity for multidisciplinary collaboration.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"758-765"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between hearing loss and body injuries caused by various firearms at a war site: A retrospective study.","authors":"Ceren Karaçaylı, Nail Durucan Özaydın, Kemal Şimşek, Bülent Satar","doi":"10.14744/tjtes.2025.52347","DOIUrl":"10.14744/tjtes.2025.52347","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the relationship between trauma severe enough to cause physical injury and subsequent hearing loss in military personnel exposed to blast events.</p><p><strong>Methods: </strong>A retrospective review was conducted on 95 patients aged 30-39 who were admitted between 2015 and 2018 due to blast-related injuries and acoustic trauma. A control group of 51 military personnel without complaints was included. Patients were categorized based on the location of trauma, the energy level of the explosion, and the presence of tympanic membrane perforation. Hearing thresholds and clinical characteristics were compared between groups to evaluate the relationship between trauma patterns and auditory outcomes.</p><p><strong>Results: </strong>Patients with head-related injuries had significantly worse air and bone conduction thresholds at multiple frequencies compared to those with injuries in other body regions (p<0.05). Tympanic membrane perforation was significantly associated with eye injuries (p=0.004) and elevated air conduction thresholds (p<0.05), but not with bone conduction thresholds. Exposure to medium and high-energy blasts was associated with elevated hearing thresholds across all frequencies compared to controls (p<0.001).</p><p><strong>Conclusion: </strong>Blast-related acoustic trauma is associated with hearing loss across a range of frequencies. Tympanic membrane perforation contributes to air conduction hearing loss. Eye injury may be anatomically related to tympanic membrane damage. Hearing assessment should be integrated into the multidisciplinary care of trauma patients in war zones.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"747-757"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection and classification of femoral neck fractures from plain pelvic X-rays using deep learning and machine learning methods.","authors":"Hüseyin Fatih Sevinç, Kemal Üreten, Talha Karadeniz, Gökhan Koray Gültekin","doi":"10.14744/tjtes.2025.75806","DOIUrl":"10.14744/tjtes.2025.75806","url":null,"abstract":"<p><strong>Background: </strong>Femoral neck fractures are a serious health concern, particularly among the elderly. The aim of this study is to diagnose and classify femoral neck fractures from plain pelvic X-rays using deep learning and machine learning algorithms, and to compare the performance of these methods.</p><p><strong>Methods: </strong>The study was conducted on a total of 598 plain pelvic X-ray images, including 296 patients with femoral neck fractures and 302 individuals without femoral neck fractures. Initially, transfer learning was applied using pre-trained deep learning models: VGG-16, ResNet-50, and MobileNetv2.</p><p><strong>Results: </strong>The pre-trained VGG-16 network demonstrated slightly better performance than ResNet-50 and MobileNetV2 for de-tecting and classifying femoral neck fractures. Using the VGG-16 model, the following results were obtained: 95.6% accuracy, 95.5% sensitivity, 93.3% specificity, 95.7% precision, 95.5% F1 Score, a Cohen's kappa of 0.91, and the Receiver Operating Characteristic (ROC) curve of 0.99. Subsequently, features extracted from the convolution layers of VGG-16 were classified using common machine learning algorithms. Among these, the k-nearest neighbor (k-NN) algorithm outperformed the others and exceeded the accuracy of the VGG-16 model by 1%.</p><p><strong>Conclusion: </strong>Successful results were obtained using deep learning and machine learning methods for the detection and clas-sification of femoral neck fractures. The model can be further improved through multi-center studies. The proposed model may be especially useful for physicians working in emergency departments and for those not having sufficient experience in evaluating plain pelvic radiographs.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"783-788"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tangential gunshot injury of the right portal vein branch resulting in subacute main portal vein thrombosis: Successful treatment without hepatectomy","authors":"Khalıg Rajabli, Serhat Kaya, İlgin Özden","doi":"10.14744/tjtes.2025.25855","DOIUrl":"10.14744/tjtes.2025.25855","url":null,"abstract":"<p><p>This report describes the successful treatment (without hepatectomy) of a patient who underwent laparotomy and bullet removal for a gunshot injury to the liver at another institution. The patient was later referred for hemobilia and was found to have an un-recognized tangential injury to the right portal vein branch, resulting in portal vein thrombosis, diagnosed on the twelfth day after injury. The patient subsequently developed severe cholangitis. Hepatic arteriography did not identify the source of hemobilia. Fol-lowing thrombectomy of the main portal vein and its left branch, along with portal vein repair, bilateral external biliary drainage from the common hepatic duct was performed. Hemobilia ceased after portal revascularization. A low-volume biliary fistula developed in the early postoperative period but resolved within 17 days with gradual removal of abdominal drains. The patient experienced no further complications during six months of follow-up. Standard biochemical blood tests remained within normal limits, except for slightly elevated alkaline phosphatase (167 U/L: 40-129) and gamma-glutamyl transpeptidase (100 U/L: 8-61) levels. Follow-up contrast-enhanced computed tomography scans on postoperative day 10 and at six months confirmed patency of the main portal vein and its left branch. Additionally, right lobe atrophy and left lobe hypertrophy were observed. In conclusion, applying principles from elective hepatopancreatobiliary surgery to trauma care, and avoiding major hepatectomy in the setting of severe cholangitis, played a crucial role in achieving a successful outcome.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"813-818"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of the HALP score in differentiating complicated and uncomplicated acute appendicitis.","authors":"Yılmaz Ünal, Yunushan Furkan Aydoğdu, Salih Tuncal, Aziz Mutlu Barlas, Recep Balık, Recep Aydın, İsmail Şimşek, Tuba Gülsüm Eyol Akbulut, Hüseyin Hakan Tosun, Şahin Kaymak","doi":"10.14744/tjtes.2025.97198","DOIUrl":"10.14744/tjtes.2025.97198","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is one of the most common causes of emergency abdominal surgery, and early identification of complicated cases is critical for effective clinical management. Although classical inflammatory markers such as white blood cell count (WBC), C-reactive protein (CRP), and immature granulocyte percentage (IG%) are commonly used in diagnosis, their predictive accuracy remains limited. The HALP score (hemoglobin, albumin, lymphocyte, and platelet score), which incorporates hemoglobin, albumin, lymphocyte, and platelet levels, may offer a more comprehensive assessment by reflecting both inflammatory and immuno-nutritional status.</p><p><strong>Methods: </strong>This retrospective study included 854 patients who underwent appendectomy between January 2022 and December 2023 at a tertiary care center. Based on surgical and pathological findings, patients were categorized into two groups: complicated and uncomplicated appendicitis. Demographic data, along with hemoglobin, albumin, lymphocyte, platelet, WBC, CRP, and IG% values, were recorded. The diagnostic performance of these parameters was statistically evaluated.</p><p><strong>Results: </strong>Among the 854 patients, 112 (13.1%) were diagnosed with complicated appendicitis. Complicated cases showed a signifi-cantly higher median age and a predominance of female patients. CRP, WBC, IG%, and platelet levels were significantly elevated in the complicated group, while hemoglobin, albumin, and lymphocyte counts were lower. The HALP score was significantly lower in patients with complicated appendicitis compared to those with uncomplicated appendicitis (median: 32.8 vs. 53.4, p<0.001). Among the evalu-ated markers, the HALP score demonstrated the highest diagnostic performance (area under the curve [AUC]: 0.732), followed by CRP (AUC: 0.706), IG% (AUC: 0.645), and WBC (AUC: 0.574).</p><p><strong>Conclusion: </strong>The HALP score is a valuable and easily applicable biomarker for predicting complicated acute appendicitis. It outperforms traditional inflammatory markers by incorporating parameters that reflect both systemic inflammation and immuno-nutritional status. Routine use of the HALP score in emergency surgical evaluations may facilitate early identification of high-risk patients and guide clinical decision-making. Prospective, multicenter studies are needed to further validate its clinical utility.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 7","pages":"621-626"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}