1
|
Az A, Sogut O, Akdemir T, Dogan Y. Intradermal Sterile Water Injection: Safe and Effective Alternative for Relief of Acute Renal Colic in the Emergency Department. J Emerg Med 2024; 66:83-90. [PMID: 38267297 DOI: 10.1016/j.jemermed.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/05/2023] [Accepted: 10/01/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND The optimal pain relief method for acute renal colic in the emergency department remains controversial. OBJECTIVE We compared the safety and efficacy of intradermal sterile water injection (ISWI) to treatment with intramuscular (IM) diclofenac, intravenous (IV) opioids, and IV paracetamol in patients with acute renal colic. METHODS This randomized, single-blind study included 320 patients with renal colic to one of four treatment groups. The first group received ISWI at four different points around the most painful flank area. Patients in the DI, PARA, and TRAM groups received 75 mg IM diclofenac, 1 g IV paracetamol, and 100 mg IV tramadol, respectively. Pain intensity was measured using a visual analog scale (VAS) before treatment and 15, 30, and 60 min after treatment. RESULTS VAS scores 15 and 30 min after treatment were significantly lower in group ISWI than in groups DI, PARA, and TRAM. However, there were no significant differences in the decrease in the pain score at baseline and at 60 min after treatment. In addition, fewer patients required rescue analgesia in group ISWI than in group TRAM. However, no significant differences were observed between group ISWI and group DI or PARA in terms of the need for rescue analgesia. Finally, there were significantly fewer adverse events in group ISWI than in groups DI and TRAM. CONCLUSIONS ISWI had similar efficacy, faster pain relief, and lower need for rescue analgesia compared with diclofenac, paracetamol, and tramadol for the management of acute renal colic. In addition, ISWI was well-tolerated and had no adverse effects.
Collapse
Affiliation(s)
- Adem Az
- Department of Emergency Medicine, Istanbul Beylikduzu State Hospital, Istanbul, Turkey
| | - Ozgur Sogut
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Tarik Akdemir
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Yunus Dogan
- Department of Emergency Medicine, Mus State Hospital, Mus, Turkey
| |
Collapse
|
2
|
Ozden MF, Sogut O, Az A, Dogan Y. Analysis of Age-Specific Predictors of Mortality in Patients with Coronavirus Disease 2019. Niger J Clin Pract 2024; 27:244-251. [PMID: 38409154 DOI: 10.4103/njcp.njcp_507_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/16/2023] [Indexed: 02/28/2024]
Abstract
AIM We investigated predictors of mortality, including demographic, clinical, and laboratory parameters, in hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia. PATIENTS AND METHODS This retrospective, single-center study included 651 consecutive Turkish adults who had been admitted to the emergency department with a diagnosis of COVID-19. We recorded the demographic, clinical, and laboratory parameters of the patients. The patients were divided into two groups: patients aged ≥65 years and patients aged <65 years. The predictors of mortality for hospitalized COVID-19 patients were evaluated. RESULTS The study included 651 patients (354 [54.4%] men and 297 [45.6%] women; mean age, 56.40 ± 15.70 years). The most common comorbidities were hypertension (37.6%), diabetes mellitus (28.9%), and coronary artery disease (CAD) (16.1%). The overall mortality rate was 10.6% (n = 69); the mortality rate was higher in men than in women. Advanced age; chronic renal failure (CRF); prolonged activated partial thromboplastin time; high serum neutrophil and platelet counts; high C-reactive protein to albumin (CRP/albumin) ratio; and high levels of albumin, lactate dehydrogenase (LDH), and high-sensitivity troponin I (TnI-hs) were independent predictors of mortality in all age groups. CONCLUSION Multivariate logistic regression analysis showed that chronic obstructive pulmonary disease (COPD), high serum platelet count, high CRP/albumin ratio, and high levels of albumin, TnI-hs, and D-dimer were independent predictors of mortality in patients aged <65 years. Conversely, advanced age, CAD, CRF, and high levels of serum CRP and LDH were independent predictors of mortality in patients aged ≥65 years.
Collapse
Affiliation(s)
- M F Ozden
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - O Sogut
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - A Az
- Department of Emergency Medicine, Istanbul Beylikdüzü State Hospital, Istanbul, Turkey
| | - Y Dogan
- Department of Emergency Medicine, Mus State Hospital, Mus, Turkey
| |
Collapse
|
3
|
Az A. Jellybean-Induced Intoxication: A Case Series of Unintentional Synthetic Cannabinoid Exposure in Children and Adults. Am J Forensic Med Pathol 2023; 44:358-361. [PMID: 37432966 DOI: 10.1097/paf.0000000000000858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
ABSTRACT Synthetic cannabinoids are illegal substances designed to mimic the effects of natural cannabinoids, typically smoked, although liquid formulations have emerged recently. This report highlights a series of cases ranging from a 2-year-old child to an adult who presented with symptoms of intoxication after consuming jellybeans containing liquefied synthetic cannabinoids. A 2-year-old child exhibited mental status changes, somnolence, tachycardia, dilated pupils, and flushed skin, and the 8- and 11-year-old children presented with anxiety, abdominal pain, vomiting, and nausea. The adult patient was more complicated, as his symptoms were consistent with acute coronary syndrome, but his angiography showed normal coronary arteries. It is important for forensic medical professionals and emergency physicians to be aware of the possibility of unintentional atypical exposure to synthetic cannabinoids and to handle suspected cases with care as part of their medical approach. These substances can have a range of effects on the body, and their use can lead to serious health consequences and even mortality.
Collapse
Affiliation(s)
- Adem Az
- From the Istanbul Beylikduzu State Hospital, Department of Emergency Medicine, Istanbul, Turkey
| |
Collapse
|
4
|
Az A, Orhan C, Sogut O. Suicide attempts and the factors that lead to suicidal ideation: A 3-year analysis. North Clin Istanb 2023; 10:745-753. [PMID: 38328720 PMCID: PMC10846586 DOI: 10.14744/nci.2023.81598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/05/2022] [Accepted: 01/07/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE We explored the epidemiological characteristics of suicide attempts and identified suicide trends and associated factors. METHODS This retrospective, cross-sectional, observational, and single-center study included consecutive 412 patients who were admitted to Emergency Department for follow-up and treatment after a suicide attempt between June 2019 and June 2022. We assessed patient demographics, suicidal behavior, previous suicide attempts, psychiatric disorders, drug use, visits to the psychiatry clinic within the past 6 months, the persistence of suicidal ideation, and clinical outcomes. RESULTS The study population consisted of 259 females (62.86%) and 153 males (37.14%), with a mean age of 29.50±11.51 (range: 13-72) years. Females attempted suicide more often than males, but suicide completion was more common in males. Overall, 79.37% (n=327) of the suicide attempters were aged <40 years and most were 20-29 years old (n=147, 35.68%). Non-fatal suicide attempts were more common in single, unemployed, and poorly educated individuals, but this was not the case for suicide completers. However, there was no significant difference in marital status, education, and occupation among suicide completers. Drug poisoning was the major form of suicide attempt (n=345, 83.74%). Mental disorders, family or relationship conflicts, and separation from a partner were common causes of suicidal ideation. Patient numbers were particularly high in the autumn (i.e., September), and at night. CONCLUSION Females, young adults, singletons, the unemployed, and individuals with psychiatric disorders and low education levels are more likely to attempt suicide, particularly during hours when they are likely to be alone.
Collapse
Affiliation(s)
- Adem Az
- Department of Emergency Medicine, Istanbul Provincial Health Directorate Beylikduzu Public Hospital, Istanbul, Turkiye
| | - Cigdem Orhan
- Department of Emergency Medicine, Istanbul Provincial Health Directorate Beylikduzu Public Hospital, Istanbul, Turkiye
| | - Ozgur Sogut
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye
| |
Collapse
|
5
|
Sut R, Az A, Cakmak S, Sogut O. Evaluation of the trauma-specific frailty index in geriatric trauma patients according to the new World Health Organization age classification. North Clin Istanb 2023; 10:711-717. [PMID: 38328733 PMCID: PMC10846567 DOI: 10.14744/nci.2022.65785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/06/2022] [Accepted: 12/13/2022] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE We compared the 15-variable trauma-specific frailty index and traditional injury scoring systems to determine trauma severity and predict discharge disposition in geriatric trauma patients based on the old and new World Health Organization age classifications. METHODS This prospective, observational, single-center study included geriatric patients aged ≥65 years with blunt trauma. We categorized patients as elderly based on the old or new World Health Organization age classification into group I (aged 65-79 years) and group II (aged ≥a80 years), respectively. At admission, we used traditional injury scoring systems (e.g., the Glasgow coma scale, injury severity score, and revised trauma score) to determine trauma severity. We compared the Trauma-Specific Frailty Index and traditional injury scoring systems between the patient groups and evaluated them for correlations. RESULTS We included 169 geriatric patients (80 and 89 in groups I and II, respectively). The mean Trauma-Specific Frailty Index score was significantly higher among females than males (p=0.025) and group II than group I (p=0.021). No significant correlations were observed in terms of the Trauma-Specific Frailty Index and traditional injury scoring systems in both groups. The mean Trauma-Specific Frailty Index score was significantly different between the hospitalized and discharged patients in group I (p=0.005), but not in group II (p=0.526). CONCLUSION The 15-variable Trauma-Specific Frailty Index score is superior to traditional injury scoring systems for managing and predicting discharge disposition in geriatric trauma patients aged 65-79 years.
Collapse
Affiliation(s)
- Rumeysa Sut
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye
| | - Adem Az
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye
| | - Sumeyye Cakmak
- Department of Emergency Medicine, University of Health Sciences, Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkiye
| | - Ozgur Sogut
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye
| |
Collapse
|
6
|
Torun E, Az A, Akdemir T, Solakoğlu GA, Açıksarı K, Güngörer B. Evaluation of the risk factors for falls in the geriatric population presenting to the emergency department. ULUS TRAVMA ACIL CER 2023; 29:897-903. [PMID: 37563898 PMCID: PMC10560798 DOI: 10.14744/tjtes.2023.07433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/18/2023] [Accepted: 04/23/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND We evaluated risk factors and frailty assessments to identify fall-prone geriatric patients in the emergency department (ED). METHODS This prospective study included 264 consecutive patients aged ≥65 years who presented to the ED. The participants were divided into those who had fallen or not. The patient groups were compared in terms of age, sex, presenting complaints (falls vs. others), comorbidities, medications, frailty assessment tools, and orthostatic hypotension (OH). RESULTS In total, 264 patients were included: 129 (48.8%) patients who had fallen and 135 (51.2%) who hadn't fallen. The mean ages of patients who had fallen and those who had not fallen were 80.48±8.38 and 79.42±7.94 years, respectively. In addition, 62.01% (n=80) and 51.85% (n=70) of patients were females. There were no statistically significant differences between the groups in terms of age or sex (P=0.290 and P=0.096, respectively). In total, 89.92% (n=116) of patients who had fallen had at least one chronic medical condition. There was a significant difference in the proportion of patients with OH between the groups. Frailty scores such as the Edmonton Frail Scale, Frail Non-Disabled Questionnaire, PRISMA-7 questionnaire, Identification of Seniors at Risk test, and Rockwood Clinical Frailty Scale scores were also significantly different between the groups. A higher PRISMA-7 score at admission was found to be an independent predictor of fall risk. CONCLUSION Falls occur more frequently in the older population and in females. In addition, the frailty assessment scores, except for the FRESH Frailty Scale, were associated with falls in geriatric patients. After elimination of non-significant variables in multivariate analysis, a high PRISMA-7 questionnaire score at admission was identified as an independent predictor of fall risk.
Collapse
Affiliation(s)
- Eltaf Torun
- Department of Emergency Medicine, Istanbul Medeniyet University, Faculty of Medicine, İstanbul-Türkiye
| | - Adem Az
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, İstanbul-Türkiye
| | - Tarık Akdemir
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, İstanbul-Türkiye
| | - Görkem Alper Solakoğlu
- Department of Emergency Medicine, Istanbul Medeniyet University, Faculty of Medicine, İstanbul-Türkiye
| | - Kurtuluş Açıksarı
- Department of Emergency Medicine, Istanbul Medeniyet University, Faculty of Medicine, İstanbul-Türkiye
| | - Bülent Güngörer
- Department of Emergency Medicine, University of Health Sciences, Etlik City Hospital, Ankara-Türkiye
| |
Collapse
|
7
|
Yesilalioglu S, Az A, Sogut O, Ergenc H, Demirel I. Systemic inflammatory markers for distinguishing uncomplicated and complicated acute appendicitis in adult patients. North Clin Istanb 2023; 10:507-513. [PMID: 37719245 PMCID: PMC10500250 DOI: 10.14744/nci.2022.79027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/04/2022] [Accepted: 08/01/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the predictive power of serum systemic inflammatory markers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-eosinophil ratio (MER), and C-reactive protein (CRP) levels for distinguishing uncomplicated and complicated acute appendicitis in adult patients admitted to the emergency department (ED). METHODS This retrospective, cross-sectional, observational, and single-center study enrolled 212 consecutive adult patients with acute appendicitis who were admitted to the ED of our tertiary care university hospital between January 1, 2019 and December 31 2021. Patients were divided into two groups (Group I, uncomplicated acute appendicitis; Group II, complicated appendicitis) according to their surgical findings and histopathological examination. Systemic inflammatory markers measured on admission were compared among patients to identify factors associated with complicated acute appendicitis. RESULTS A total of 132 patients, 83 male (62.9%) and 49 female (37.1%), were included in the study. The mean age was 34.7±13.40 years. Based on the histopathological examination, the number of patients in Group I was 103 (78.03%) and 29 (21.96%) in Group II. Laboratory findings on admission revealed no significant differences between Groups I and II patients in terms of mean serum NLR, MER, and CRP values (p=0.096, p=0.248, and p=0.297, respectively). However, the mean serum PLR in Group II patients was statistically significantly higher than those in Group I (p=0.032). The mean serum monocyte and monocyte fraction (%) values were significantly lower, and the mean serum neutrophil fraction (%) value was higher in Group II patients compared to those with Group I. Receiving operator characteristic (ROC) analysis identified a serum PLR cutoff value of ≥133.73 for distinguishing uncomplicated and complicated acute appendicitis in adult patients, with 60% sensitivity and 58.4% specificity. In addition, ROC analysis revealed a cutoff monocyte fraction (%) level of ≤6, with 72% sensitivity and 64% specificity, for distinguishing uncomplicated and complicated acute appendicitis in adult patients. CONCLUSION Our findings indicate that the mean serum NLR, MER, and CRP values measured on admission to ED in adult patients with acute appendicitis could not predict complicated acute appendicitis. However, mean serum PLR and neutrophil and monocyte counts can be useful in distinguishing complicated cases.
Collapse
Affiliation(s)
- Secil Yesilalioglu
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye
| | - Adem Az
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye
| | - Ozgur Sogut
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye
| | - Huseyin Ergenc
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye
| | - Ilhami Demirel
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye
| |
Collapse
|
8
|
Topaloglu MS, Sogut O, Az A, Ergenc H, Akdemir T, Dogan Y. The impact of meteorological factors on the spread of COVID-19. Niger J Clin Pract 2023; 26:485-490. [PMID: 37203114 DOI: 10.4103/njcp.njcp_591_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Background Clinical studies suggest that warmer climates slow the spread of viral infections. In addition, exposure to cold weakens human immunity. Aim This study describes the relationship between meteorological indicators, the number of cases, and mortality in patients with confirmed coronavirus disease 2019 (COVID-19). Patients and Methods This was a retrospective observational study. Adult patients who presented to the emergency department with confirmed COVID-19 were included in the study. Meteorological data [mean temperature, minimum (min) temperature, maximum (max) temperature, relative humidity, and wind speed] for the city of Istanbul were collected from the Istanbul Meteorology 1st Regional Directorate. Results The study population consisted of 169,058 patients. The highest number of patients were admitted in December (n = 21,610) and the highest number of deaths (n = 46) occurred in November. In a correlation analysis, a statistically significant, negative correlation was found between the number of COVID-19 patients and mean temperature (rho = -0.734, P < 0.001), max temperature (rho = -0.696, P < 0.001) or min temperature (rho = -0.748, P < 0.001). Besides, the total number of patients correlated significantly and positively with the mean relative humidity (rho = 0.399 and P = 0.012). The correlation analysis also showed a significant negative relationship between the mean, maximum, and min temperatures and the number of deaths and mortality. Conclusion Our results indicate an increased number of COVID-19 cases during the 39-week study period when the mean, max, and min temperatures were consistently low and the mean relative humidity was consistently high.
Collapse
Affiliation(s)
- M S Topaloglu
- Department of Emergency Medicine, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - O Sogut
- Department of Emergency Medicine, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - A Az
- Department of Emergency Medicine, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - H Ergenc
- Department of Emergency Medicine, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - T Akdemir
- Department of Emergency Medicine, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Y Dogan
- Department of Emergency Medicine, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| |
Collapse
|
9
|
Karaman MI, Az A, Az A. The Evaluation of the First Bahname Written in Turkish in the Ottoman Era Concerning Current Urology. Turk J Urol 2022; 48:446-454. [PMID: 36416335 PMCID: PMC9797757 DOI: 10.5152/tud.2022.22104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Our study investigated the oldest known Turkish bahname, translated by Musa b. Mes'ud, in comparison with the current literature. MATERIAL AND METHODS First, the original manuscript of the translation was transcribed in Latin. The final version of the text was analyzed in the results. In discussion, findings were examined and interpreted within the framework of current knowledge of sexology, urology, and andrology. RESULTS Although the work mostly mentions supportive and therapeutic practices in sexual health, it also provides advice on sexuality and sexual life, discussing several topics regarding sexual intercourse types, explaining which ones are good or harmful, and their timing or frequency. The author recommends many foods and compounds or specific drugs and ointments to enhance sexual stamina and avoid erectile dysfunc tion. In addition, he also tries to find solutions to some other sexual health problems related to men and women. These issues are generally evaluated in the context of health; a religious perspective is also provided when needed. CONCLUSION Interestingly, the author's recommendations on sexual health and herbal or animal drugs are consistent with the current literature. Nevertheless, some information and suggestions in works are entirely irrational and unscientific. Consequently, this study is an original investigation of the first translated bahname into Turkish. There is no other study examining the bahnames with this method. Thus, we believe that our work will be a significant contribution to the research literature.
Collapse
Affiliation(s)
- Muhammet Ihsan Karaman
- Department of Medical History and Ethics, İstanbul Health and Technology University, İstanbul, Turkey
| | - Adem Az
- Department of Medical History and Ethics, İstanbul University Faculty of Medicine, İstanbul, Turkey,Corresponding author:Adem Az E-mail:
| | | | | |
Collapse
|
10
|
Ümit TB, Sogut O, Az A, Cakmak S, Demirel I. Relationship between measures of thoracic diameter and cardiopulmonary resuscitation-induced thoracoabdominal injury. Rev Assoc Med Bras (1992) 2022; 68:1470-1475. [DOI: 10.1590/1806-9282.20220822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - Adem Az
- University of Health Sciences, Turkey
| | | | | |
Collapse
|
11
|
Az A, Dogan Y, Sogut O, Akdemir T, Kaplan O. Bleeding events in the emergency department with warfarin versus novel oral anticoagulants: A five-year analysis. Niger J Clin Pract 2022; 25:1308-1317. [DOI: 10.4103/njcp.njcp_125_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
12
|
Az A, Sogut O, Akdemir T, Ergenc H, Dogan Y, Cakirca M. Impacts of Demographic and Clinical Characteristics on Disease Severity and Mortality in Patients with Confirmed COVID-19. Int J Gen Med 2021; 14:2989-3000. [PMID: 34234528 PMCID: PMC8254610 DOI: 10.2147/ijgm.s317350] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/04/2021] [Indexed: 12/26/2022] Open
Abstract
Background We investigated potential predictive factors for mortality and disease severity from demographic and clinical data, comorbidities, and laboratory findings in patients with confirmed COVID-19 who were consecutively admitted to our tertiary hospital. Methods In this retrospective, single-center, observational study, we enrolled consecutive 540 adult patients who had COVID-19 confirmed by a molecular method. Patients were categorized into three groups based on disease severity. Patients’ demographic and clinical characteristics, mortality rates, and mortality-associated factors were analyzed. Results The overall mortality rate was 4.3% (23/540). Disease severity was mild in 40.9% (n = 221), severe in 53.7% (n = 290), and critical in 5.4% (n = 29) of the patients. There were significant differences among groups in terms of median white blood cell (WBC), hemoglobin, neutrophil, lymphocyte, and thrombocyte counts, as well as C-reactive protein (CRP), procalcitonin, lactate dehydrogenase (LDH), creatinine, albumin, D-dimer, ferritin, troponin, and fibrinogen levels. Furthermore, there were significant differences between surviving and non-surviving patient groups in terms of median WBC, hemoglobin, neutrophil, and lymphocyte counts, as well as CRP, procalcitonin, LDH, creatinine, albumin, D-dimer, and ferritin levels. CRP level (odds ratio [OR]: 1.020, 95% confidence interval [CI]: 1.009–1.032; p < 0.001), and CURB-65 score (OR: 4.004, 95% CI: 1,288–12,447; p = 0.017) were independently associated with disease severity and mortality. Conclusion On admission, WBC, neutrophil, lymphocyte, and platelet counts can be used to predict disease severity in patients with COVID-19. CRP, ferritin, LDH, creatinine, troponin, D-dimer, fibrinogen, and albumin levels can also be used to predict disease severity in these patients. Finally, elevated CRP level and high CURB-65 score were predictors of disease severity and mortality.
Collapse
Affiliation(s)
- Adem Az
- University of Health Sciences, Haseki Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey
| | - Ozgur Sogut
- University of Health Sciences, Haseki Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey
| | - Tarik Akdemir
- University of Health Sciences, Haseki Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey
| | - Huseyin Ergenc
- University of Health Sciences, Haseki Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey
| | - Yunus Dogan
- University of Health Sciences, Haseki Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey
| | - Mustafa Cakirca
- Bezmialem Vakif University, Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey
| |
Collapse
|
13
|
Yeniocak S, Yıldırım S, Az A, Demirel A, Özden MF, Uzun Ö. A case of multitrauma with vena cava inferior isthmus injury. Journal of Emergency Medicine Case Reports 2020. [DOI: 10.33706/jemcr.516924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
14
|
Yeni̇ocak S, Az A, Özden MF, Demi̇rel A, Akdemi̇r T, Uzun Ö. A rare case of posterior sternoclavicular joint dislocation in a motorcycle rider. MED SPORT 2019. [DOI: 10.23736/s0025-7826.19.03466-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|