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Öğe Dicle University Hospital's hospital disaster plan and emergency service management: Kahramanmaras earthquake experience(Oxford Univ Press, 2024) Yaman, Mahmut; Ulgut, Silan Goger; Sen, Abdullah; Ulgut, Ali Firat; Belek, Sema; Durgun, Hasan MansurBackground: Hospitals, being establishments with varying functions and capacities, must have disaster plans that reduce vulnerability, ensure the continuity, and possibly increase the capacity of healthcare services; these measures are crucial for reducing mortality and facilitating the normalization of life after a disaster. In this study, the aim was to analyze the operational process of the disaster management plan at Dicle University Faculty of Medicine Hospital following the earthquake in Kahramanmara & scedil; on 6 February 2023. Methods: This is a retrospective observational study. The study focused on determining the role of the hospital's disaster plan in crisis situations, specifically examining the emergency service task distribution and management. Results: The study included patients aged 1 to 85 years (median 34, mean 36.9 +/- 19.0), with 52.5% being female. The median injury severity score was 17 (mean 20.1 +/- 19.2). Hospital admission was 65.7%, with nephrology and orthopedics being the most common departments. Higher injury severity scores were significantly associated with mortality (P < .05), and dialysis and surgery rates were significantly higher in deceased patients (P < .05). No significant differences were found in age, gender, or comorbidities between groups. Conclusion: The earthquake highlighted the importance of disaster preparedness in hospitals for effective patient care, collaboration among disciplines, and resource management. Detailed data on the hospital's disaster plan and its operational process during the earthquake were provided to underscore its critical role in managing the crisis. Lessons learned will shape future disaster response protocols, stressing continual evaluation and improvement in healthcare disaster readiness.Öğe Evaluating the McMahon score for predicting mortality in earthquake-induced rhabdomyolysis: a retrospective study(Oxford Univ Press, 2024) Yaman, Mahmut; Sen, Abdullah; Durgun, Hasan Mansur; Eynel, Eren; Belek, Sema; Ulgut, Silan Goger; Orak, MuratBackground: In natural disasters like earthquakes, building collapses can trap individuals, causing crush syndrome and rhabdomyolysis. This life-threatening condition often leads to acute kidney injury. We aimed to determine the effectiveness of the McMahon score in predicting mortality due to rhabdomyolysis in patients affected by the earthquake. Methods: This is a retrospective observational study. In this study, the clinical and laboratory data of patients who presented to the emergency department due to the earthquake were analyzed. The McMahon score was calculated by evaluating factors such as creatine kinase, serum creatinine levels, age, and gender. Results: The study included 151 patients, of whom 74 (49.0%) were male and 77 (51.0%) were female. In the univariate model, significant (P < .05) effectiveness was observed in differentiating between patients with and without mortality for McMahon score and the risk of acute kidney injury. At a McMahon score cutoff of 6, significant effectiveness was also observed, with an area under the curve of 0.723. At this cutoff value, the sensitivity was 80.0% and the specificity was 64.5%. Conclusions: The use of the McMahon score in emergency medicine and disaster management plays a crucial role in rapid decision-making processes due to its effectiveness in predicting mortality. Key messages What is already known on this topic center dot Rhabdomyolysis, often associated with crush syndrome and acute renal failure, leads to elevated serum creatinine levels due to muscle breakdown, frequently seen in trauma and earthquake victims. What this study adds center dot The McMahon score helps predict mortality and acute kidney injury in rhabdomyolysis patients, particularly after earthquakes, by evaluating key clinical and demographic factors. How this study might affect research, practice, or policy center dot This study highlights the McMahon score's reliability in predicting mortality in rhabdomyolysis patients, potentially guiding future research on early intervention strategies and trauma management, informing clinical practices for rapid assessment and treatment.Öğe The prognostic value of HALP score and sPESI in predicting in-hospital mortality in patients with pulmonary thromboembolism(Oxford Univ Press, 2024) Yaman, Mahmut; Orak, Murat; Durgun, Hasan Mansur; Tekin, Veysi; Ulgut, Silan Goger; Belek, Sema; Gunel, Bercem TugayBackground Pulmonary thromboembolism (PTE), often arising from deep vein thrombosis, remains a high-mortality condition despite diagnostic advancements. Prognostic models like Pulmonary Embolism Severity Index (PESI) and sPESI identify low-risk groups effectively. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, reflecting nutritional status and systemic inflammation, shows prognostic value in cancers and cardiovascular diseases. This study examines the relationship between in-hospital mortality HALP score and simplified PESI (sPESI) in PTE patients. Methods This retrospective observational study included patients diagnosed with PTE in the emergency department of a tertiary medical faculty from 2018 to 2023. PTE diagnosis was confirmed via computed tomography pulmonary angiography. Data on transthoracic echocardiography, D-dimer levels, demographics, laboratory results, PESI, sPESI, and HALP scores, and in-hospital mortality were collected. Results In this study, clinical characteristics of 171 patients with PTE were analysed. The average age was 61.88 +/- 19.94 years, and 53.2% were female. Mortality was observed in 19.3% of patients. PESI and sPESI scores were significant predictors of mortality, with area under the curve values of 0.938 and 0.879, respectively. PESI score > 175.50 indicated a significantly higher mortality risk (HR = 18.208; P < .001), while sPESI >2.50 was also a strong predictor (HR = 11.840; P < .001). No significant cut-off value for HALP in predicting mortality was identified. Conclusions Our study supports the reliability of sPESI and PESI scores in predicting in-hospital mortality in PTE patients. However, the prognostic value of the HALP score requires further investigation. Our findings highlight the need for developing risk stratification models.Öğe The Impact of Lactate Clearance, Bilirubin, and Albumin on Mortality in Elderly COPD Patients: Insights from Emergency Department Data(Türkiye Acil Tıp Derneği, 2024) Yaman, Mahmut; Şen, Abdullah; Durgun, Hasan Mansur; Belek, Sema; Orak, Murat; Tekin, Veysi; Gündüz, ErcanAim: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterized by symptoms such as cough, dyspnea, and airflow limitation. The prevalence and health risks of COPD increase with age, making emergency interventions crucial for elderly patients. This study investigated the influence of bilirubin, lactate clearance, and albumin levels on mortality rates among elderly COPD patients in emergency settings to inform treatment strategies and improve clinical outcomes. Material and Methods: Elderly patients diagnosed with COPD were included in this retrospective cohort study. Data on demographics, clinical presentations, laboratory results, comorbidities, and outcomes were collected. Biochemical measurements were performed via biochemical analyses and arterial blood gas analyses. Results: Among the 139 patients studied, 89 (64%) were male with a mean age of 75 years. The mortality rate was 7.92%. No significant differences were observed in age, sex distribution, or comorbidities between deceased and surviving patients. Lactate clearance and bilirubin levels did not significantly affect mortality. However, albumin levels were notably lower in deceased patients (p
