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

{"title":"Forensic medical evaluation of penetrating abdominal injuries.","authors":"Canan Eryiğit İbiş, Fatma Süheyla Aliustaoğlu","doi":"10.14744/tjtes.2024.16177","DOIUrl":"10.14744/tjtes.2024.16177","url":null,"abstract":"<p><strong>Background: </strong>This study aims to discuss the characteristics, origins, degree of injury, results, reporting, and forensic medical aspects of penetrating abdominal injuries.</p><p><strong>Methods: </strong>In this study, 28,619 cases who applied to the emergency department of Kutahya Health Sciences University Evliya Celebi Training and Research Hospital between January 1, 2016 and December 31, 2020 were reviewed. The forensic reports and medical documents of 85 cases with penetrating abdominal injuries were evaluated retrospectively, with the approval of the ethics committee.</p><p><strong>Results: </strong>Among the patients included in the study, 87.1% were male and 12.9% were female. The mean age was found to be 31±13 years. When the origins of the cases were analyzed, 87.1% were found to have developed as a result of intentional injury. The incidents predominantly occurred between 20: 00 and 04: 00 hours. As a result of the examinations performed at the hospital after the incident, alcohol was detected in 36.5% of the cases, while 30.6% of the individuals did not consume alcohol. It was observed that 32.9% of the cases were not tested for alcohol. The most common injuries identified were sharp injuries, accounting for 69.4% of cases, and firearm injuries, comprising 27.1%. Organ damage was noted in 68.2% of the cases, with the small intestine being the most frequently damaged organ. The average number of wounds present was 3.6. Intra-abdominal hemorrhage was detected in 61.2% of the cases, and intra-abdominal artery injuries were found in 8.2%. The mortality rate for penetrating abdominal injuries was 8.2%.</p><p><strong>Conclusion: </strong>In forensic traumatology, penetrating abdominal injuries commonly lead to life-threatening conditions and loss of organ function, which represent the most severe category in trauma severity assessment. Penetrating abdominal injuries most often result from violent incidents, as observed in our study and in the literature.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"30 8","pages":"537-545"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877128","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":"Early versus delayed lower extremity amputations caused by firearm injury: A minimum 2-year follow-up.","authors":"Mustafa Aydın, Ali Murat Başak, Ömer Levent Karadamar, Begüm Aslantaş, Ali Aydilek, Tolga Ege, Deniz Cankaya","doi":"10.14744/tjtes.2024.36276","DOIUrl":"10.14744/tjtes.2024.36276","url":null,"abstract":"<p><strong>Background: </strong>High-energy casualties such as firearm injuries may result in extensive loss of soft tissue and bone in the lower extremities. Although the primary aim in these types of injuries is the preservation of the extremity, repeated surgical procedures for extremity salvage and subsequent restoration of function could have detrimental effects on the patient both physically and psychologically. The main aim of this study is to evaluate the physical and psychological outcomes of patients who underwent lower extremity amputation in the early period after a firearm injury compared with the results of patients who underwent amputation in the late period. We also evaluated the factors affecting the prognosis in patients undergoing late below-knee amputation (BKA).</p><p><strong>Methods: </strong>This retrospective study included patients who underwent BKA following a lower extremity injury caused by firearms between March 2016 and March 2022. Patients who underwent emergency BKA at the first center they were taken to immediately after the injury constituted the early amputation (EA) group. Patients who were transferred to our tertiary-level referral center for continuation of treatment after the first intervention at another center and later underwent BKA constituted the late amputation (LA) group. The patients were evaluated regarding age, gender, amputation side, presence of phantom limb pain (PLP), and post-traumatic stress disorder (PTSD).</p><p><strong>Results: </strong>Information was available from hospital records for a total of 35 patients; 16 in the EA group and 19 in the LA group. All patients were male. The mean age at the time of injury was 25.5±5.3 years (range, 20-45 years), and the mean follow-up period was 37±17 months (range, 25-84 months). In the comparison of PLP experienced, the difference between the groups was statistically significant, with PLP experienced by 1 (10%) patient in the EA group and by 9 (90%) in the LA group (p=0.010). PTSD was diagnosed in 3 (23%) patients in the EA group and 10 (77%) patients in the LA group (p=0.039).</p><p><strong>Conclusion: </strong>Patients who underwent late BKA were found to be affected by PLP and PTSD at a higher rate. When deciding on extremity-preserving surgery for patients with severe open injuries to the lower extremity, it is crucial to consider the poor outcomes associated with late BKA. Patients should be thoroughly informed about these negative outcomes.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"30 8","pages":"610-616"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877125","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 challenging decision for emergency physicians: Routine repeat computed brain tomography of the brain in head trauma in infants and neonates.","authors":"Burak Katipoglu, Nurullah İshak Işık, Ömer Faruk Turan, Safa Dönmez, Yusuf Yavuz, Ensar Durmuş, Attila Bestemir, Dariusz Timler","doi":"10.14744/tjtes.2024.28368","DOIUrl":"10.14744/tjtes.2024.28368","url":null,"abstract":"<p><strong>Background: </strong>Head trauma is a leading cause of death and disability. While standard treatment protocols exist for severe head trauma, no clear follow-up standards are available for mild head trauma with positive imaging findings in infants and newborns. Although routine follow-up brain computed tomography (CT) imaging is not recommended for children with moderate and mild head trauma, the necessity for follow-up imaging in infants and newborns remains uncertain.</p><p><strong>Methods: </strong>Our study is a retrospective, observational, and descriptive study. Infants under 1 year old presenting to the emergency department with isolated head trauma were reviewed with the approval of the Ethics Committee of Ankara Etlik City Hospital. Inclusion criteria included presentation to the emergency department, undergoing more than one brain CT scan, and sustaining mild head trauma (Glasgow Coma Scale [GCS] >13). Patients with incomplete follow-up data or multiple traumas were excluded. Age, gender, mechanism of trauma, initial and follow-up brain CT findings, hospital admission, and surgical procedures were recorded and analyzed using the SPSS statistical package.</p><p><strong>Results: </strong>Out of 238 screened patients, 154 were included in the study. Of these, 66.9% were male and the average age was 5.99 months. The most common presenting symptom was swelling at the trauma site, observed in 79.2% of cases. The most common mechanism of injury was falling from a height of less than 90 cm, accounting for 85.1% of cases. Pathological progression on follow-up CT was observed in 5.2% of the patients, and only 1.9% required surgical treatment. A total of 34.4% of the patients required hospitalization. Patients with parenchymal brain pathology had a higher rate of pathological progression on follow-up CT and a longer hospital stay.</p><p><strong>Conclusion: </strong>Follow-up CT scans in infants with mild head trauma do not alter patient outcomes except in cases with brain parenchymal pathology. Study data indicated that repeat imaging is not beneficial for isolated skull fractures. Imaging artifacts often necessitated repeated scans, contributing to increased radiation exposure. Unnecessary repeat imaging escalates radiation exposure and healthcare costs. Only a small percentage of patients exhibited progression of intracranial pathology, justifying follow-up imaging solely in the presence of brain parenchymal injury. Larger prospective studies are necessary to confirm these findings.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"30 8","pages":"596-602"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877120","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":"Effect of three different exercise trainings on functional capacity in early stage severe burn patients: A randomized controlled trial.","authors":"Murat Ali Çınar, Kezban Bayramlar, Ahmet Erkılıc, Ali Güneş, Yavuz Yakut","doi":"10.14744/tjtes.2024.59987","DOIUrl":"10.14744/tjtes.2024.59987","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the effects of three different exercise protocols on functional capacity in early-stage burn patients.</p><p><strong>Methods: </strong>A total of 25 patients hospitalized in the Burn Center (wards and intensive care unit) were included in the study. The individuals were divided into three groups by covariate adaptive randomization according to burn percentage and type: 1 - standard treatment, 2 - standard treatment + aerobic exercise training, 3 - standard treatment + combined exercise (aerobic and resistance) determined by metabolic status. Individuals were evaluated weekly for six weeks from the first day of hospitalization using the 6-minute walk test, physiological cost index, and Medical Research Council muscle-strength measurements to assess functional capacity. A portable metabolism tracker device measured the metabolic status of all patients.</p><p><strong>Results: </strong>Aerobic exercises and combined exercise (aerobic and resistance), when added to standard treatment and determined by metabolic status, were more effective in enhancing functional capacity than standard treatment alone (p<0.05). Patients performing the combined exercise (aerobic and resistance) showed faster improvement in functional capacity determined according to metabolic status than those in the other two groups (p<0.05).</p><p><strong>Conclusion: </strong>Aerobic exercises, when added to standard treatment and combined with aerobic and resistance exercises based on metabolic status, are more effective at improving functional capacity than standard treatment alone. Further controlled studies are required to explore the potential long-term benefits of this approach.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"30 8","pages":"562-270"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877126","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":"Data analysis of patients admitted to the emergency medicine clinic of Mersin City Training and Research Hospital after the Kahramanmaraş earthquake.","authors":"Zikret Köseoğlu, Tamer Çolak, İnan Beydilli, Giray Altunok, Kemal Şener, Kaddafi Demir, Ahmet Uzan, Süleyman Söker","doi":"10.14744/tjtes.2024.68523","DOIUrl":"10.14744/tjtes.2024.68523","url":null,"abstract":"<p><strong>Background: </strong>In earthquakes and other natural disasters, there is a significant number of injuries directly resulting from trauma. Additionally, due to the disaster's impact on overloaded health institutions, healthcare providers face significant challenges during earthquakes. In this context, nearby hospitals providing health services play a crucial role. Nonetheless, with proper planning, the health crisis can be managed in the best possible way.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted on patients admitted to Mersin City Training and Research Hospital due to injuries attributed to the earthquake that occurred in the southern and mid-eastern regions of Türkiye on February 6, 2023. A total of 2,155 patients meeting the study criteria were included in the analysis.</p><p><strong>Results: </strong>Of the 2,155 patients enrolled in the study, 46.8% (n=1009) were male, with a mean age of 45.86±17.68 years. Falls (57.2%, n=1233) were the most common mechanism of injury, and 71.9% (n=1550) of cases presented to the hospital on their own. Among the head injuries, the most common types were soft tissue injury and lacerations, while soft tissue injury and rib fractures were most common in the thoracic region. Soft tissue injury and retroperitoneal bleeding were the most commonly recorded types among abdominal injuries, whereas soft tissue injury and fractures were most common in the upper and lower extremities. Fractures were identified in 11.1% (n=240) of cases in the upper extremities and 21.3% (n=458) in the lower extremities. Rhabdomyolysis was one of the most frequently observed injury types (n=443, 20.6%). Crush syndrome and acute kidney injury were recorded in 9.2% (n=198) of cases, leading to a total of 46 amputations in 40 (1.8%) patients and 164 fasciotomies in 132 (6.1%) patients. The orthopedics department performed the most frequent surgical interventions and hospitalizations. Mortality was noted in 2.87% (n=62) of cases.</p><p><strong>Conclusion: </strong>This study demonstrated a significant increase in workload and patient volume following the earthquake. There is a need for a large number of healthcare professionals for expedient intervention in conditions such as fractures, crush syndrome, amputation, and fasciotomy in disasters with a high risk of serious trauma, such as earthquakes. Disaster planning and preparedness for possible consequences will mitigate the healthcare crisis involving the hospitals and lead to significant reductions in mortality and morbidity.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"30 8","pages":"579-587"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877123","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":"Acil servis tanıları ile paramediklerin ilk değerlendirme tanılarının karşılaştırılması.","authors":"Ramiz Yazıcı, Efe Demir Bala, Burak Bekgöz, Eyup Sari, Ayse Fethiye Basa Kalafat, Ozgur Omer Yildiz, Utku Murat Kalafat, Serkan Dogan","doi":"10.14744/tjtes.2024.90463","DOIUrl":"10.14744/tjtes.2024.90463","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the accuracy and quality of prehospital assessments and preliminary diagnoses made by Emergency Medical Services (EMS) providers compared to the final diagnoses given by Emergency Department physicians in a metropolitan area.</p><p><strong>Methods: </strong>This retrospective observational study utilized records from the Yenimahalle EMS Command Center in Ankara, Türkiye, from January 1, 2021, to December 31, 2022. Data were recorded as cases rather than individual patients, with repeated EMS admissions counted separately. Cases were categorized by EMS call time, reasons for EMS requests, age, gender, nationality, and weekday of hospital arrival to assess socioeconomic impacts and congestion patterns. The study included 2.528 pediatric cases, excluding patients aged 18 and older, those who refused EMS transfer, and cases resolved at the scene. Data analysis was conducted using IBM SPSS 27.0, with statistical significance set at p<0.05.</p><p><strong>Results: </strong>The study included 2.528 cases. The data revealed that EMS providers had an average of 9.9±4.7 years of experience. In 1.839 cases (72.7%), the EMS provider was female, and in 689 cases (27.3%), the EMS provider was male. Patients had an average age of 9.2±5.8 years, with 1.173 (46.4%) being female and 1.355 (53.6%) being male. Preliminary diagnosis accuracy was higher in cases involving younger and male patients. Additionally, a lower preliminary diagnosis accuracy rate was observed during office hours (08: 00-15: 59) compared to non-office hours (16: 00-23: 59). The majority of EMS calls were for medical reasons (1,783 cases, 70.5%), followed by trauma-related calls (745 cases, 29.5%).</p><p><strong>Conclusion: </strong>This study highlights the need for improved on-field training for EMS providers to enhance the accuracy and quality of prehospital assessments and preliminary diagnoses. The findings suggest that younger and male patients have higher preliminary diagnosis accuracy rates, and there is a noticeable decrease in accuracy during office hours, indicating potential areas for targeted training and protocol adjustments.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"30 8","pages":"554-561"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877121","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":"Violence and bullying at school: 10-year data from the Forensic Medicine Department of a University Hospital in Türkiye.","authors":"Çağdaş Savaş, Nazlıcan Aras, Gizem Gençoğlu, Mehmet Hakan Özdemir","doi":"10.14744/tjtes.2024.93955","DOIUrl":"10.14744/tjtes.2024.93955","url":null,"abstract":"<p><strong>Background: </strong>Violence at school is broadly defined as a range of acts including physical, psychological, and sexual violence, as well as bullying. These can occur at school, in the school environment, on the way to school, or in any school-related environment. Considering the school environment as the place where a child spends most of their daily life, its impact on the child's life cannot be underestimated. This study aims to contribute to the literature by sharing characteristics of school violence and bullying cases with forensic reports prepared in our department, and by presenting solution suggestions for detecting and preventing these issues.</p><p><strong>Methods: </strong>Between January 1, 2012 and December 31, 2022, a total of 14,330 forensic reports issued by the Dokuz Eylül University Faculty of Medicine, Department of Forensic Medicine, were analyzed. It was found that 125 cases involved school violence. Five cases involving non-students were excluded, leaving 120 student cases for inclusion in the study. Sociodemographic data, type of violence, incident location, educational stage, injury origin, and psychiatric assessment results were assessed. Statistical analysis of the data was performed using the SPSS 29.0 package.</p><p><strong>Results: </strong>Of the 120 cases analyzed, 90 (75%) were male, and 30 (25%) were female. The cases were most frequently subjected to violence at the secondary education stage (n=73, 60.8%) and, secondarily, at the primary education stage (n=36, 30%). When the type of violence was analyzed, it was found that physical violence was the most common (n=96, 80%), followed by sexual violence (n=21, 17.5%). Among these, 91.1% (n=82) of males and 43.3% (n=13) of females were exposed to physical and sexual violence, respectively. A statistically significant relationship was found between the type of violence and gender (p<0.001). Post-traumatic stress disorder (PTSD) was the most common diagnosis among those who underwent psychiatric assessments after experiencing violence (n=15, 45.5%).</p><p><strong>Conclusion: </strong>To effectively combat violence and bullying, we believe that strategies based on analyzing the causes of bullying in schools across different cultures, planning and implementing appropriate interventions tailored to the problem area, and preventing recurrence by disseminating the results will yield more effective outcomes.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"30 8","pages":"617-624"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877131","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 associated with thirty-day mortality and intensive care unit admission in patients undergoing hip fracture surgery.","authors":"Elvan Tekir Yılmaz, Yiğit Şahin, Bilge Olgun Keleş, Ali Altınbaş","doi":"10.14744/tjtes.2024.24186","DOIUrl":"10.14744/tjtes.2024.24186","url":null,"abstract":"<p><strong>Background: </strong>Various factors contribute to the development of mortality and morbidity in hip fracture surgeries. This study aims to investigate the effects of modifiable factors such as the type of anesthesia, anesthesia management, surgical method, and timing of surgery on 30-day mortality rates, intensive care unit admissions, and complications.</p><p><strong>Methods: </strong>A total of 400 patients who underwent hip fracture surgery between January 2021 and December 2023 at a Training and Research Hospital were retrospectively analyzed. Patients were divided into two groups: those followed in the ward, named Group 1 (n=304), and those in the intensive care unit, named Group 2 (n=96). Recorded data included demographic characteristics, American Society of Anesthesiologists (ASA) physical status scores, types of comorbidities, anesthesia type, surgical method, surgical delay time, duration of surgery, blood transfusion requirements, and complications.</p><p><strong>Results: </strong>Patients in Group 2 had higher mean age, comorbidity, and mortality rates compared to Group 1 (p<0.001). In terms of types of comorbidities, the rate of intensive care unit admission was higher in patients with coronary artery disease and chronic renal failure (p<0.001). Mean surgical delay and length of hospital stay were also higher in Group 2 (p<0.001). In multivariate logistic regression analysis, age (p<0.001, Odds Ratio [OR]=1.91, Confidence Interval [CI]=1.046-1.137), ASA score (p<0.001, OR=3.872, CI=1.913-7.838), duration of surgical delay (p<0.001, OR=2.029, CI=1.365-3.017), surgical method (p=0.003, OR=2.003, C=1.258-3.188), and length of hospital stay (p=0.006, OR=1.147, CI=1.04-1.266) were determined as predictive factors for 30-day mortality.</p><p><strong>Conclusion: </strong>This study found that age, ASA classification, length of hospital stay, surgical method, and surgical delay were predictive factors for both morbidity and mortality. Among these, surgical delay time appears to be a modifiable parameter when all factors are considered.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"30 8","pages":"571-578"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877127","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":"Mortality risk factors for crush syndrome after an earthquake in Türkiye: Do systemic inflammatory parameters play any role?","authors":"Mediha Türktan, Ömer Doğan, Mehmet Gökhan Gök, Kaniye Aydın, Ersel Güleç, Zehra Hatipoğlu, Yusuf Kemal Arslan, Dilek Özcengiz","doi":"10.14744/tjtes.2024.09637","DOIUrl":"10.14744/tjtes.2024.09637","url":null,"abstract":"<p><strong>Background: </strong>The aim of our study is to assess the prognostic impact of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) on 28-day mortality in patients admitted to the intensive care unit with crush syndrome following the Kahramanmaraş earthquake in Türkiye.</p><p><strong>Methods: </strong>A total of 63 adult patients with crush syndrome admitted to the intensive care unit after the earthquake were enrolled in this study. The medical records of the patients were examined using follow-up forms and the hospital data system.</p><p><strong>Results: </strong>The mean age of the patients was 38.9±17.3 years, and the median time under debris was 31.5 hours. The 28-day mortality rate was 27%. In univariate generalized estimating equations (GEE) and other analyses, variables that are significant (or candidate variables) between 28-day mortality groups included age as a biological factor. These variables were included in the multivariate GEE model. The effects of continuous renal replacement therapy (CRRT), serum sodium concentration, Sequential Organ Failure Assessment (SOFA) score, and PLR on mortality were statistically significant.</p><p><strong>Conclusion: </strong>Elevated SOFA scores, the necessity for CRRT, increased serum sodium levels, and decreased PLR values are associated with increased 28-day mortality in patients with crush syndrome after an earthquake.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"30 8","pages":"588-595"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877129","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":"Prediction of anemia with thoracic computed tomography findings.","authors":"Zeynep Ayvat Öcal, Fatoş Dilan Köseoğlu","doi":"10.14744/tjtes.2024.31531","DOIUrl":"10.14744/tjtes.2024.31531","url":null,"abstract":"<p><strong>Background: </strong>This study explored the potential of non-contrast thoracic computed tomography (CT) to predict anemia by correlating CT parameters with hemoglobin (Hb) levels in patients who underwent non-contrast thoracic CT for various indications.</p><p><strong>Methods: </strong>This retrospective study included 150 patients who underwent non-contrast thoracic CT scans and complete blood counts within 24 hours at our center between January and June 2023. Exclusion criteria included acute bleeding, iron accumulation disorders, recent transfusions, pregnancy, and certain thoracic CT artifacts. Hounsfield Unit (HU) measurements were obtained from the ascending aorta, left ventricular cavity, and descending aorta, and compared with Hb and hematocrit (Htc) values. Anemia indicators such as the 'Aortic Ring Sign (ARS)' and the 'Hyperdense Septum Sign (HSS)' were also evaluated.</p><p><strong>Results: </strong>Anemic patients (48%) exhibited significantly lower HU measurements at all three CT scan locations and higher instances of ARS and HSS compared to non-anemic patients. Notably, the presence of HSS and ARS was strongly associated with anemia. Thresholds for HU measurements corresponding to anemia were determined using receiver operating characteristic curve analysis, which also revealed strong positive correlations between HU measurements and Hb/Htc levels.</p><p><strong>Conclusion: </strong>The study concludes that non-contrast thoracic CT parameters, particularly HU measurements and the presence of ARS and HSS, are significantly associated with anemia. These CT indicators could serve as reliable, non-invasive markers for predicting anemia in patients, potentially aiding in the early diagnosis and management of the condition.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"30 8","pages":"531-536"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877130","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}