Muhammed Kadir Yıldırak, Hanife Seyda Ulgur, Mert Gedik, Enes Sertkaya, Emre Furkan Kırkan, F. Ezberci, H. Tolan, Adnan Özpek
{"title":"Is it possible to predict mortality in patients with high-grade blunt liver injury? A single trauma center study.","authors":"Muhammed Kadir Yıldırak, Hanife Seyda Ulgur, Mert Gedik, Enes Sertkaya, Emre Furkan Kırkan, F. Ezberci, H. Tolan, Adnan Özpek","doi":"10.14744/tjtes.2024.60646","DOIUrl":"https://doi.org/10.14744/tjtes.2024.60646","url":null,"abstract":"BACKGROUND\u0000Blunt abdominal trauma constitutes a significant portion of trauma cases and is often associated with liver injury. Given that high-grade liver injuries remain life-threatening, identifying patients who will likely require more vigilant attention and care is crucial. This study aims to determine the parameters that increase mortality in patients with high-grade liver trauma.\u0000\u0000\u0000METHODS\u0000This study enrolled 38 patients with Grade III or higher liver injuries, treated by the general surgery department between 2008 and 2023. Eleven patients who died were categorized into Group 1, and 27 survivors were placed in Group 2. We evaluated their respective mechanisms of injury, imaging results, Glasgow Coma Scale scores, Base Excess, Lactate levels, pH, and Injury Severity Score findings. Receiver Operating Characteristics (ROC) analysis was performed for parameters with significant differences, and certain cutoff values were determined.\u0000\u0000\u0000RESULTS\u0000The grade of liver injury and additional abdominal organ injuries were significantly higher in Group 1 (p<0.05). The difference in extra-abdominal injury sites was statistically insignificant between the groups (p>0.05). Erythrocyte suspension requirements were significantly higher in Group 1 (p<0.05). Average lactate and base deficit values were also significantly higher in Group 1 (p<0.05), while leukocyte counts were significantly lower in Group 1 (p<0.05).\u0000\u0000\u0000CONCLUSION\u0000Base deficit, hemoglobin (Hb), lactate levels, injury severity, liver injury grade, accompanying abdominal injuries at admission, and erythrocyte suspension demands were found to be associated with increased mortality rates. Certain cutoff values for the aforementioned parameters could be established. However, further data are required to confirm these findings.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140775049","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}
E. Kınacı, M. Sevinç, Anil Demir, Emre Erdoğan, Fatih Alper Ahlatci, U. Idiz
{"title":"Changes in cytokines and chemokines in an acute pancreatitis model.","authors":"E. Kınacı, M. Sevinç, Anil Demir, Emre Erdoğan, Fatih Alper Ahlatci, U. Idiz","doi":"10.14744/tjtes.2024.18049","DOIUrl":"https://doi.org/10.14744/tjtes.2024.18049","url":null,"abstract":"BACKGROUND\u0000The immune response secondary to inflammation that develops in acute pancreatitis plays an important role in the clinical course of the disease. This study aims to evaluate the changes in various cytokines and chemokines according to the severity of pancreatitis.\u0000\u0000\u0000METHODS\u0000Twenty-one female Wistar albino rats were divided into three equal groups. The control group received no intervention. Intraperitoneal cerulein was administered to the other groups once per hour for five hours at doses of 50 µg/kg and 80 µg/kg for the mild and severe pancreatitis groups, respectively. The development of pancreatitis and its severity level were confirmed by histological evaluation after euthanization. Blood samples were taken from all rats to measure levels of Interleukin-10 (IL-10), Interferon gamma (IFN-γ), C-X-C Motif Chemokine Ligand 1 (CXCL-1), Monocyte Chemoattractant Protein-1 (MCP-1), Tumor Necrosis Factor alpha (TNF-α), Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF), IL-18, IL-12p70, IL-1β, IL-17A, IL-33, IL-1α, and IL-6. Additionally, the Schoenberg inflammation scores of pancreatic tissues were evaluated.\u0000\u0000\u0000RESULTS\u0000The acute pancreatitis model was successfully induced in all cases within the study groups, according to histopathological examination. It was found that the levels of CXCL-1, MCP-1, and IL-6 were statistically significantly higher in rats with pancreatitis, with these parameters being elevated in the group with severe pancreatitis. In correlation analyses, MCP-1 and IL-6 showed a moderate correlation with the severity of pancreatitis.\u0000\u0000\u0000CONCLUSION\u0000CXCL-1, MCP-1, and IL-6 exhibit predictive characteristics for the occurrence and clinical course of pancreatitis. Our results highlight the production and working pathways of these cytokines as potential targets for therapeutic intervention.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140757476","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}
Ömer Faruk Karakoyun, Zeynep Nisa Karakoyun, Elif Aylin Yüce Yörük, Mustafa Buğra Coşkun, Yalçın Gölcük
{"title":"The impact of ankle kinesio taping on pain management in patients with acute ankle sprain.","authors":"Ömer Faruk Karakoyun, Zeynep Nisa Karakoyun, Elif Aylin Yüce Yörük, Mustafa Buğra Coşkun, Yalçın Gölcük","doi":"10.14744/tjtes.2024.55494","DOIUrl":"https://doi.org/10.14744/tjtes.2024.55494","url":null,"abstract":"BACKGROUND\u0000The objective of this study was to assess the efficacy of Kinesio Tape (KT) application as a complementary treatment for patients with acute ankle sprain (AAS) in an Emergency Department (ED) setting.\u0000\u0000\u0000METHODS\u0000A prospective, quasi-randomized controlled trial was conducted in a tertiary care ED. Adult patients diagnosed with isolated, stable Grade 1 and Grade 2 AAS were included. Patients were divided into two groups: the KT group, where KT was applied in addition to conventional treatment, and the control group, receiving only conventional treatment. Pain intensity, analgesic usage, and patient satisfaction were assessed.\u0000\u0000\u0000RESULTS\u0000While pain levels were similar between both groups at baseline and the 30th minute, the control group reported significantly lower pain levels at the 60th minute (p=0.575, p=0.437, and p=0.042, respectively). The KT group exhibited reduced analgesic drug consumption and higher patient satisfaction levels (p<0.001 and p=0.003, respectively). Logistic regression analysis revealed that the difference in pain intensity at the 60th minute lost significance, while analgesic usage and patient satisfaction remained significant (p=0.631, p=0.003, and p=0.026, respectively).\u0000\u0000\u0000CONCLUSION\u0000KT application, as a complementary treatment, may reduce the need for analgesics and enhance patient satisfaction in patients with AAS in the ED. Further research is needed to refine its application and confirm its effectiveness in standard AAS treatment protocols.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787096","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}
Vefa Cakmak, D. Herek, A. Oskay, Gülay Gungör, Pinar Cakmak, Mert Özen
{"title":"Pancreatic injury due to blunt trauma on CT: does retropancreatic fat tissue reduce the severity of pancreatic injury?","authors":"Vefa Cakmak, D. Herek, A. Oskay, Gülay Gungör, Pinar Cakmak, Mert Özen","doi":"10.14744/tjtes.2024.60622","DOIUrl":"https://doi.org/10.14744/tjtes.2024.60622","url":null,"abstract":"BACKGROUND\u0000Pancreatic injuries from blunt abdominal trauma have a high mortality rate, often accompanied by injuries to adjacent organs. This study aims to investigate the relationship between the size of retropancreatic adipose tissue and the severity of pancreatic and adjacent organ injuries in patients with pancreatic trauma.\u0000\u0000\u0000METHODS\u0000We retrospectively screened computed tomography (CT) images of 34 patients (25 males, nine females, aged 13-69 years) and 34 controls (28 males, six females, aged 15-66 years) who suffered blunt abdominal trauma. The area of adipose tissue located posterior to the pancreatic body was measured in the axial plane for all subjects. The severity of pancreatic injury was assessed in terms of the injury site, the retropancreatic adipose tissue area, and the degree of other organ injuries.\u0000\u0000\u0000RESULTS\u0000Pancreatic injuries were located in the head for 16 patients (23.5%), in the body for four patients (5.9%), and in the tail for 14 patients (20.6%). The retropancreatic fat area was found to be significantly smaller in patients with pancreatic trauma compared to controls (p<0.0001). Furthermore, the ratio of the retropancreatic fat area to the vertebral corpus area differed significantly between patients with and without pancreatic injuries (p=0.014).\u0000\u0000\u0000CONCLUSION\u0000Retropancreatic adipose tissue protects the pancreatic body from the impacts of blunt abdominal trauma. An increased amount of retropancreatic adipose tissue is associated with a reduced rate of pancreatic injury.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763965","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}
{"title":"Non-malignant left colon emergency surgery: evaluation of factors affecting clinical outcomes and complications.","authors":"M. Çiftçi, Burak Uçaner, M. Buldanlı","doi":"10.14744/tjtes.2024.40009","DOIUrl":"https://doi.org/10.14744/tjtes.2024.40009","url":null,"abstract":"BACKGROUND\u0000Emergency colorectal resections hold a significant position in general surgical practice, and pathologies of the left colon are relatively common. This study was conducted to assess the outcomes of isolated left colon surgeries with benign etiologies, drawing on clinicopathological and biochemical data.\u0000\u0000\u0000METHODS\u0000We carried out a retrospective review and statistical analysis of demographic, clinical, and laboratory data of patients who underwent left colon surgery at the general surgery clinic of a tertiary care hospital, excluding those with malignancy-related emergencies, from January 2017 to January 2022.\u0000\u0000\u0000RESULTS\u0000The average age of the 48 patients in the study was 56.9±16.4 years. Complicated acute diverticulitis was the most frequent indication for emergency surgery (n=19, 39.6%). The Hartmann procedure was the surgical technique most often employed (n=30, 62.5%). The rates of postoperative morbidity and mortality within 30 days were 27.1% and 8.3%, respectively. Increased postoperative morbidity was linked to advanced age (mean 65.4±15.8 vs. 53.8±15.7, p=0.028), the preoperative administration of vasopressors, lower platelet counts, hypoalbuminemia (<3 mg/dl), and azotemia (blood urea nitrogen >20 mg/dl). There was no statistically significant correlation between comorbidities, American Society of Anesthesiologists (ASA) scores, surgical methods, or other clinical data and postoperative outcomes.\u0000\u0000\u0000CONCLUSION\u0000For emergency colorectal surgery pertaining to left colon pathologies, it is critical to conduct a comprehensive evaluation in the perioperative period, especially for elderly and hypotensive patients with renal function abnormalities and for those requiring vasopressors.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755901","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}
{"title":"Use of hyperbaric oxygen therapy in severe earthquake injuries.","authors":"Levent Demir, Mustafa Öztürk","doi":"10.14744/tjtes.2024.60979","DOIUrl":"10.14744/tjtes.2024.60979","url":null,"abstract":"<p><strong>Background: </strong>Earthquakes are natural disasters that can often cause severe injuries and traumatic situations. These injuries can include crush injuries, fractures, tissue damage, and blood circulation problems. Hyperbaric oxygen therapy (HBOT) has recently become a frequently used treatment modality for individuals suffering from severe injuries. HBOT is a form of treatment that involves administering pure oxygen to the patient under high pressure. This treatment aims to promote tissue healing by increasing cellular oxygenation. It is thought to have a positive effect on factors such as accelerating tissue healing, reducing inflammation, and controlling infection in severe post-earthquake injuries, particularly crush injuries. This study aimed to retrospectively evaluate the clinical effects, contributions to the healing process, and potential advantages of HBOT in 35 patients with severe injuries after the Kahramanmaraş earthquake that occurred on 06.02.2023 and to contribute to the development of emergency intervention strategies.</p><p><strong>Methods: </strong>This study was carried out after ethics committee approval. In the study, the data of patients with a MESS Score between 7-14 who were admitted as earthquake victims and treated in the HBOT Unit due to severe earthquake-related injuries were obtained from records and retrospectively analyzed. Demographic information, general distribution of patient data, mean values, number of HBOT sessions, and functional outcomes were recorded.</p><p><strong>Results: </strong>The gender distribution of the 35 patients who received HBOT was 31.4% male and 68.6% female. 45.7% of patients were aged 18 years or younger, and 54.3% were aged 19 years or older. The most common injuries in the treated patients were observed in the lower extremities. After HBOT, sensory recovery (54.3%) and functional recovery (51.4%) were achieved in the majority of patients. The minor amputation rate was 20.0% and the major amputation rate was 11.4% after HBOT.</p><p><strong>Conclusion: </strong>This study evaluated the possible effects of HBOT on patients with severe earthquake injuries in Türkiye, and the results showed that HBOT may have a beneficial effect on critical factors such as sensory recovery, functional recovery, and amputation rates in this particular group of patients, and that this benefit may be more pronounced in those who started treatment early.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178487","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":"A rare cause of intestinal obstruction: right paraduodenal hernia.","authors":"Tuba Atak","doi":"10.14744/tjtes.2023.20352","DOIUrl":"10.14744/tjtes.2023.20352","url":null,"abstract":"<p><p>Internal herniation is an extremely rare cause of intestinal obstruction. Paraduodenal hernias result from abnormal rotation of the bowel. Symptoms that may range from recurrent abdominal pain to acute obstruction may occur. If it is not diagnosed and treated in time, the disease may result in intestinal ischemia. This article aimed to present the diagnosis and treatment process of a 47-year-old male presenting with acute abdomen symptoms by evaluating retrospectively with the accompaniment of literature. During the abdominal exploration of the patient, nearly all of the intestines were observed to be herniated from the right paraduodenal region to the posterior area. The opening of the hernial sac was repaired primarily by reducing the intestinal bowel loops into the intraperitoneal region. The patient undergoing anastomosis by performing resection of the ischemic part after reduction of herniated bowel loops was discharged uneventfully on the post-operative 10th day. Paraduodenal hernia is a condition that should be considered in patients with abdominal pain and intestinal obstruction symptoms. Early diagnosis is of vital importance to prevent the complications which can develop.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178517","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":"Anesthetic approach to trauma patients in the city hospital after the 2023 Maraş earthquake.","authors":"Aylin Kılınçarslan, Ceyda Özhan Caparlar, Müge Çakırca, Fatma Özkan Sipahioğlu, Funda Atar, Selma Ölmez, Nur Yılmaz, Merve Karaşahin, Derya Özkan","doi":"10.14744/tjtes.2024.92346","DOIUrl":"10.14744/tjtes.2024.92346","url":null,"abstract":"<p><strong>Background: </strong>The February 6, 2023, Kahramanmaraş earthquake caused significant destruction across our country. More than 50,000 people lost their lives, thousands were injured, and health facilities were damaged. Victims were transferred to hospitals in other provinces for treatment. This study evaluates the anesthesia approach applied to the injured who were transferred to our tertiary hospital.</p><p><strong>Methods: </strong>We retrospectively reviewed the data of patients who underwent surgery between February 6 and February 20, 2023. The study included earthquake victims who underwent emergency trauma surgery, aged 10 years and above. We recorded the date of admission to the hospital, demographic information, type of surgery, surgical site, anesthesia technique, preference for peripheral block, laboratory values, dialysis and intensive care needs, and survival rates. Data analysis was performed using the IBM® Statistical Package for the Social Sciences (SPSS®) Version 26.0.</p><p><strong>Results: </strong>A total of 375 cases were included in the study. Of these, 323 patients underwent surgery for extremity injuries, and 35 for vertebral injuries. Among the extremity injuries, 61.6% were to the lower extremities, and 17.1% to the upper extremities. Debridement was performed on 147 patients, fasciotomy on 49 patients, and amputation on 33 patients. General anesthesia was applied to 352 patients, spinal anesthesia to 19 patients, and sedoanalgesia to four patients. Peripheral nerve block was performed on 33 patients. Dialysis treatment was administered to 105 patients. Twenty-six patients were lost during the treatment process. There were no intraoperative patient deaths.</p><p><strong>Conclusion: </strong>The predominance of extremity injuries among earthquake victims increases the inclination towards regional anesthesia. Incorporating Plan A blocks into basic anesthesia skills could enhance the preference for regional anesthesia in disaster situations. Furthermore, transferring the injured to advanced centers may reduce morbidity.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178518","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}
Engin Onan, Dilek Torun, Rüya Kozanoğlu, Hasan Miçözkadıoğlu, Salih Beyaz, Levent Özgözen, Necmettin Turgut, Yusuf Ziya Demiroğlu, Özlem Karagün, Pınar Ergenoğlu, Özlem Özkan Kuşçu, Ege Altan, Alper Tuna Güven, Alim Abdullayev, İsmail Karluka, Çiğdem Yalçın, Mustafa Mazıcan, İsa Göktürk Balcı, Burak Özkan, Gönül Parmaksız, Begüm Avcı, Aytül Noyan, Turan Çolak, Hüseyin Ali Tünel, Abdulkerim Temiz, Hasan Özkan Gezer, Cankat Erdoğan, Galib Bairamoi, Dilek Yünlüel, Soner Çivi, Emre Durdağ, Özgür Kardeş, Halil İbrahim Süner, Kadir Tufan, Serkan Erkan, Tevfik Avcı, Ramazan Gündoğdu, Murat Kuş, Alper Fındıkçıoğlu, Oya Yıldız, Eda Alışkan, Cenk Coşkunoğlu, Mehmet Haberal
{"title":"Mortality Factors in Crush Syndrome.","authors":"Engin Onan, Dilek Torun, Rüya Kozanoğlu, Hasan Miçözkadıoğlu, Salih Beyaz, Levent Özgözen, Necmettin Turgut, Yusuf Ziya Demiroğlu, Özlem Karagün, Pınar Ergenoğlu, Özlem Özkan Kuşçu, Ege Altan, Alper Tuna Güven, Alim Abdullayev, İsmail Karluka, Çiğdem Yalçın, Mustafa Mazıcan, İsa Göktürk Balcı, Burak Özkan, Gönül Parmaksız, Begüm Avcı, Aytül Noyan, Turan Çolak, Hüseyin Ali Tünel, Abdulkerim Temiz, Hasan Özkan Gezer, Cankat Erdoğan, Galib Bairamoi, Dilek Yünlüel, Soner Çivi, Emre Durdağ, Özgür Kardeş, Halil İbrahim Süner, Kadir Tufan, Serkan Erkan, Tevfik Avcı, Ramazan Gündoğdu, Murat Kuş, Alper Fındıkçıoğlu, Oya Yıldız, Eda Alışkan, Cenk Coşkunoğlu, Mehmet Haberal","doi":"10.14744/tjtes.2024.20532","DOIUrl":"10.14744/tjtes.2024.20532","url":null,"abstract":"<p><strong>Background: </strong>Crush Syndrome is a major cause of morbidity and mortality following large-scale catastrophic earthquakes. Since there are no randomized controlled studies on Crush Syndrome, knowledge on this subject is limited to expert experience. The primary objective is to analyze the epidemiological and demographic characteristics, clinical outcomes, and mortality factors of earthquake victims after the Pazarcik and Elbistan earthquakes on February 6, 2023.</p><p><strong>Methods: </strong>This cross-sectional and observational retrospective study evaluated 610 earthquake victims who presented to our center between February 6 and April 30, 2023. Among these patients, 128 with Crush Syndrome were included in the study. Patient information was gathered from hospital records during their stay and from national registries upon referral. The primary outcome was to identify risk factors for mortality. Demographic and laboratory data were analyzed by acute kidney injury (AKI) stages; mortality-affecting factors were identified through regression analysis.</p><p><strong>Results: </strong>Of the 128 Crush Syndrome patients (100 adults, 28 children), 64 were female. The AKI rate was 32.8%. Among patients with AKI, the frequency of hemodialysis requirement was 69%, and the mortality rate was 14.2%. The overall mortality rate for patients with Crush Syndrome was 4.6%, compared to 3.9% (19/482) in earthquake victims without Crush Syndrome (p=0.705). Notably, low systolic blood pressure at admission was the only factor significantly affecting mortality in Crush Syndrome patients (Hazard Ratio [HR]: 1.088, p=0.021, 95% Confidence Interval [CI]).</p><p><strong>Conclusion: </strong>Our study highlights low systolic blood pressure upon admission as a significant risk factor for increased mortality in Crush Syndrome patients. This finding may contribute to the literature by emphasizing the importance of monitoring blood pressure under rubble and administering more aggressive fluid therapy to patients with low systolic blood pressure.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178523","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}
Cem Erdoğan, Zeynep Betul Balcioglu, Isa Seida, Denız Kizilaslan
{"title":"Post Trauma Acinetobacter Baumanii Meningitis Treatment Approach.","authors":"Cem Erdoğan, Zeynep Betul Balcioglu, Isa Seida, Denız Kizilaslan","doi":"10.14744/tjtes.2024.65051","DOIUrl":"10.14744/tjtes.2024.65051","url":null,"abstract":"<p><p>A. baumannii, which is said to be associated with nosocomial infections is considered a significant mortality risk if not adequately addressed. A. baumannii infections typically occur in the aftermath of surgery or trauma. Our patient developed complicated A. baumannii meningitis with lateral ventriculitis and a lumbar abscess post surgery after suffering from a fall. The patient was treated with a 21-day regimen of intrathecally administered colistin and polymyxin B. Following this therapeutic period, the patient's condition improved, ultimately leading to successful recovery and subsequent discharge. This case report serves to highlight the ability of intrathecal administration of antibiotics, that normally have limited potential of crossing the blood-brain-barrier, to lead to improved survival outcomes in multi-drug resistant nosocomial meningitis.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178483","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}