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AFFECTING FACTORS ON EARLY MORTALITY IN ELDERLY PATIENTS DIAGNOSED WITH PULMONARY EMBOLISM IN EMERGENCY DEPARTMENT
(Gunes Kitabevi Ltd Sti, 2015) Zengin, Yilmaz; Gunduz, Ercan; Dursun, Recep; Icer, Mustafa; Durgun, Hasan Mansur; Taylan, Mahsuk; Guloglu, Cahfer
Introduction: The ratio of elderly people in Turkey is rapidly growing. It is known that pulmonary embolism and venous thrombolysis incidence increases with age. Despite the major advances in pulmonary embolism diagnosis and treatment, pulmonary embolism leads to higher mortality rates in the elderly. In the present study, evaluation of socio-demographic and clinical characteristics of elderly patients diagnosed with pulmonary embolism in the emergency department and determination of factors that affect early mortality have been targeted in order to decrease mortality. Materials and Method: Between January 1, 2009, and September 30, 2014, patients who were 65 years of age and older who had been admitted through the emergency department with suspected pulmonary embolism and whose pulmonary embolism diagnosis was finalized via computerized tomographic pulmonary angiography. Results: In the study, 87 (61.8%) were female and 52 (38.2%) were male. Thirteen patients (9.4%) died during the follow-up period. The analysis of the relationship between pulmonary embolism in elderly patients and early mortality revealed that there is a statistical correlation among immobility, syncope, tachycardia, hypotension, elevated Troponin-T, coronary arterial disease, cerebrovascular disease, pulmonary embolism with massive dimension, bilateral pulmonary embolism, Wells-likely pulmonary embolism, and modified Geneva-likely pulmonary embolism were statistically related factors(p values, respectively, were 0.002; 0.033; 0.000; 0.000; 0.000; 0.037; 0.011; 0.000; 0.030; 0.023; 0.018). Conclusion: Immobility, syncope, tachycardia, hypotension, elevated Troponin T, coronary arterial disease, cerebrovascular disease, pulmonary embolism with massive dimension, bilateral pulmonary embolism, Wells-likely pulmonary embolism, and modified Geneva-likely pulmonary embolism were determined as effective risk factors affecting the early mortality of elderly patients with pulmonary embolism.
AFFECTING FACTORS ON EARLY MORTALITY IN ELDERLY PATIENTS DIAGNOSED WITH PULMONARY EMBOLISM IN EMERGENCY DEPARTMENT
(2015) Zengin, Yılmaz; Gülolu, Cahfer; Dursun, Recep; İçer, Mustafa; Gündüz, Ercan; Taylan, Mahşuk; Durgun, Hasan Mansur
Giriş: Tüm dünyada olduğu gibi Türkiye'de de yaşlı nüfus oranı hızla artmaktadır. Pulmoneremboli ve venöz tromboli insidansının yaşla birlikte arttığı bilinmektedir. Pulmoner emboli tanı vetedavisindeki büyük ilerlemelere rağmen pulmoner emboli yaşlılarda daha yüksek oranda mortalite ile sonuçlanmaktadır. Bu çalışmada, acil serviste pulmoner emboli tanısı alan yaşlı hastalarınsosyodemografik ve klinik özelliklerini değerlendirmek ve mortalitenin azaltılabilmesi için erkenmortalite üzerindeki etkili faktörlerin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışma 01.01.2009 tarihi ile 30.09.2014 tarihleri arasında acil servise başvuran 65 yaş ve üzeri olan ve pulmoner emboli şüphesi ile çekilen kompüterize tomografikpulmoner anjiografilerinde pulmoner emboli tanısı kesinleşen 139 hasta hastane bilgisayar kayıtsisteminden retrospektif olarak incelendi. Bulgular: Bu çalışmada hastaların 87'si (%61,8) kadın, 52'si (%38,2)'si erkekti. Hastaların takibinde 13 kişi (9,4%) yaşamını kaybetti. Çalışmada pulmoner embolili yaşlı hastalarının acil başvuru anındaki özellikleri ile erken mortalite arasındaki faktörlerin araştırıldığı analizde immobilite,bayılma, taşikardi, hipotansiyon, Troponin T yükselmesi, koroner arter hastalığı, serebrovaskülerhastalık, masif boyutlu pulmoner emboli olması, bilateral pulmoner emboli olması, Wells skorlamasında muhtemel pulmoner emboli olması ve Modifiye Genava skorlamasında muhtemel pulmoner emboli olmasının istatistiksel olarak ilişkili faktörler olduğu tespit edildi( p değerleri sırasıyla 0,002; 0,033; 0,000; 0,000; 0,006; 0,037; 0,011; 0,000; 0,030; 0,023; 0,018).Sonuç: İmmobilite, senkop, taşikardi, hipotansiyon, Troponin T yükselmesi, koroner arterhastalığı, serebrovasküler hastalık, masif boyutlu pulmoner emboli olması, bilateral pulmoner emboli olması, Wells skorlamasında muhtemel pulmoner emboli olması ve Modifiye Genava skorlamasında muhtemel pulmoner emboli olması yaşlı pulmoner embolili hastalarda erken mortaliteüzerine etkili faktörler olarak bulunmuştur
Assessment of adult patients with hypernatremia: A single center experience
(Dicle Üniversitesi Tıp Fakültesi, 2015) Gündüz, Ercan; Zengin, Yılmaz; İçer, Mustafa; Durgun, Hasan Mansur; Dursun, Recep; Gündüzalp, Ahmet; İpek, Mustafa; Güloğlu, Cahfer
Objective: In the present study, determination of symptoms, clinical characteristics, prevalence and recovery rates was aimed in patients who applied to the emergency service and diagnosed with hypernatremia. Methods: Patients who applied to Dicle University Medical School Emergency Service during January 2013-December 2014 and whose serum Na>148 mEq/L were included in the study. The study was conducted retrospectively. Results: Hypernatremia prevalence was determined as 0.21% in the cases who applied to the emergency service. The average age in all patients was 69±22 and the median age was 72 years. The average hospitalization period was 13.3±10.9 days. The mortality rate was 75.7% and male gender domination (56%) was determined in patients who developed mortality. When mortality and recovery groups were compared statistically; significant difference was determined (p<0.05) in terms of hospitalization period, glucose, urea, creatinine and calcium averages. The complaints of our patients who applied to the emergency service were changes in consciousness (92.7%), oral intake disorder (83.4%) and fever (48.6%) based on frequency order. The accompanying comorbid states were cerebrovascular illness (36.9%), Dementia/ Alzheimer (32.4%) and hypertension (28.9%) based on frequency order. Conclusion: Consequently, hypernatremia is a fluidelectrolyte disorder progressing with high mortality and could be observed in older patients and in patients whose oral intake is defective and who have cerebrovascular illness and dementia
A Bomb explosion in Diyarbakir: Clinical findings and management of emergency department
(Dicle Üniversitesi Tıp Fakültesi, 2016) İçer, Mustafa; Zengin, Yılmaz; Durgun, Hasan Mansur; Dursun, Recep; Arı, Baran; Ekinci, Mustafa; Üstündağ, Mehmet; Orak, Murat; Güloğlu, Cahfer
Objectives: In this study, we present management of emergency department, patients’ clinical findings and mortality analysis after a bomb explosion. Methods: Patients brought to Diyarbakır Dicle University Hospital emergency department after the explosion at 5 June 2015 were retrospectively examined. Patients’ age, gender, triage, system injuries, hypotension, blood transfusion, admission to the ICU, Intensive care unit surgical treatment, amputation and trauma scores (Glasgow Coma Score (GCS), Revised Trauma Score (RTS), Injury Severity Score (ISS), Trauma Score-Injury Severity Score (TRISS), Shock index) were studied. Factors affecting emergency department management and mortality were analyzed. Results: The mean age was found as 29.64±12.88 years in survivors and 36±19.98 years in deaths. GCS, ISS and shock index were found as the factors affecting mortality (p≤0.05). Wounded taken to the resuscitation room, hypotension, blood transfusion, intubation, treatment in ICU and amputation were correlated with mortality (p<0.05). Conclusion: A fast and effective triage system must be applied in EDs following a bomb explosion. The explosion of a bomb on the open areas are the most common injury to the lower extremity injury. Mortality is most often associated with lower limb amputations.
A Case of Uncorrected Tetralogy of Fallot Undiagnosed Until Adulthood and Presenting With Polycythemia
(Elmer Press Inc, 2014) Gunduz, Ercan; Gorgel, Ahmet; Dursun, Recep; Durgun, Hasan Mansur; Cil, Habip; Icer, Mustafa; Zengin, Yilmaz
Congenital heart defects with right-to-left shunt are one of the hypoxia-related causes of acquired secondary polycythemia (SP). Tetralogy of Fallot (ToF) is the most common congenital cyanotic heart disease in children. Cases of uncorrected ToF in adult ages are rare. This paper reports a woman detected with elevated hemoglobin level during routine tests performed for infertility therapy and subsequently diagnosed SP with related ToF.
Demographic Analysis of Complications of Warfarin Treatment and Factors Affecting Mortality
(Aves, 2013) Orak, Murat; Dursun, Recep; Ustundag, Mehmet; Ozhasenekler, Ayhan; Durgun, Hasan Mansur; Guloglu, Cahfer
Objective: This study investigated the demographic analysis of complications of warfarin therapy and the factors affecting mortality. Material and Methods: The digital medical records of patients who applied to our Emergency Clinic with warfarin overdose between September 2007 and September 2010 were retrieved and patient files were assessed retrospectively. Cases were classified into two groups in terms of INR level and hemorrhagic complications; patients with an INR level greater than 3.5 and a hemorrhagic complication, and patients with an INR level greater than 3.5 and no hemorrhagic complication. Furthermore, cases with a hemorrhagic complication were divided into two subgroups as those who died and those who survived. Results: The study enrolled 151 cases presenting to our emergency clinic with warfarin overdose. Among these, 50.3% (n = 76) were males and 49.7% (n = 75) were females. Mean age was 60.80 +/- 16.11 years. There was no significant difference between the groups in terms of sex and age. Hemorrhagic complication was present in 66.89% (n = 101) while absent in 33.11% (n = 50). PT and INR levels were significantly higher in patients with hemorrhage compared to those without (for PT 90.98 +/- 26.52 vs. 55.51 +/- 12.70, respectively; p < 0.001; for INR 8.97 +/- 11.29 vs. 4.63 +/- 0.68, respectively; p = 0.042). In patients with a hemorrhagic complication who died, the PT level was significantly higher, and hematocrit and platelet levels were significantly lower than those of patients who survived a hemorrhagic complication (p < 0.001, p = 0.033, and p = 0.009, respectively). Conclusion: Education in warfarin use, regular follow-ups, self-monitorization, and increased distribution of home-type coagulometry devices will decrease the frequency of complications.
Demographic Properties of Civilians with Blast Injuries in Southeastern Anatolia Region
(2015) Akdağ, Mehmet; Kaçmaz, Ömer; Dursun, Recep; Üstündağ, Mehmet; Durgun, Hasan Mansur; Gulloglu, Cahfer; Orak, Murat
ObjectivesThe present study conducted demographic analysis of blast injuries, with the authors aiming to guide the determination of groups and regions at risk, helping hospitals take preventive measures and providing information for accurate triage, rapid intervention, multidisciplinary approach, and lowering workforce losses.MethodsThis study retrospectively examined the demographic properties of civilians who presented to the Emergency Department of Dicle University after being injured in explosions of various origins between January 2005 and September 2013 in the Southeastern Anatolia Region of Turkey.ResultsOf the study population, 85.50% were male and 14.50% were female. The explosive responsible for injury was a mine in 20.51% of the cases, a bomb in 29.06%, a squib in 14.53%, dynamite in 7.69%, and some other explosive in the remaining 28.31%. Of those injured, 35.90% were students, 21.36% were farmers, 11.10% were shepherds or drivers, and 31.62% were from other occupational groups.ConclusionsIn conclusion, injuries resulting from explosions are associated with higher morbidity and mortality rates, making it necessary to increase the number of trauma centers and emergency action teams in that region, as well as demining the region and educating the native population about explosives
Demographic properties of civilians with blast injuries in Southeastern Anatolia Region
(Türkiye Acil Tıp Derneği, 2015) Kaçmaz, Ömer; Dursun, Recep; Durgun, Hasan Mansur; Akdağ, Mehmet; Orak, Murat; Üstündağ, Mehmet; Güloğlu, Cahfer
Objectives The present study conducted demographic analysis of blast injuries, with the authors aiming to guide the determination of groups and regions at risk, helping hospitals take preventive measures and providing information for accurate triage, rapid intervention, multidisciplinary approach, and lowering workforce losses. Methods This study retrospectively examined the demographic properties of civilians who presented to the Emergency Department of Dicle University after being injured in explosions of various origins between January 2005 and September 2013 in the Southeastern Anatolia Region of Turkey. Results Of the study population, 85.50% were male and 14.50% were female. The explosive responsible for injury was a mine in 20.51% of the cases, a bomb in 29.06%, a squib in 14.53%, dynamite in 7.69%, and some other explosive in the remaining 28.31%. Of those injured, 35.90% were students, 21.36% were farmers, 11.10% were shepherds or drivers, and 31.62% were from other occupational groups. Conclusions In conclusion, injuries resulting from explosions are associated with higher morbidity and mortality rates, making it necessary to increase the number of trauma centers and emergency action teams in that region, as well as demining the region and educating the native population about explosives.
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 Mansur
Background: 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.
Diyarbakır'da Bir Bomba Patlaması: Klinik Bulgular ve Acil Servis Yönetimi
(2016) Zengin, Yılmaz; Orak, Murat; İçer, Mustafa; Durgun, Hasan Mansur; Üstündağ, Mehmet Üstündağ; Ekinci, Mustafa; Arı, Baran
Amaç: Bu çalışmada bir bombalı saldırı sonrasında acil servis yönetimi, hastaların klinik bulguları ve mortalite analizi sunulmuştur Yöntemler: Diyarbakır Dicle Üniversitesi Hastanesi Acil servisi'ne 5 Haziran 2015 tarihindeki patlama sonrası gelen hastalar retrospektif incelendi. Yaş, cinsiyet, triaj, sistem yaralanmaları, hipotansiyon, kan transfüzyonu, entübasyon, yoğun bakıma yatış, cerrahi tedavi, ampütasyon, travma skorları[Glasgow Coma Skalası (GCS) Skoru, Revize Trauma Skoru (RTS), Yaralanma Şiddet Skoru (Injury Severity Skoru -ISS), Travma Skoru-Yaralanma Şiddet Skoru (TRISS), Şok İndeksi ] incelendi. Acil servis yönetimi ve mortalite üzerine etkili faktörler analiz edildi. Bulgular: Yaşayanların yaş ortalaması 29,64±12,88 yıl ve ölenlerin yaş ortalaması 36±19,98 yıl idi. GCS, ISS, shock index mortaliteyi etkileyen faktörlerdi (p<=0,05). Resüsitasyon odasına alınan yaralılar, hipotansiyon, kan transfüzyonu, entübasyon, yoğun bakımda tedavi, cerrahi tedavi ve ampütasyon yapılması mortalite ile ilişkiliydi (p<0,05). Sonuç: Bir bombalama eyleminin ardından acil servislerde hızlı ve etkili bir triaj sistemi uygulanmalıdır. Açık alanda gerçekleşen bombalı patlamalarda en yaygın yaralanma alt ekstremite yaralanmaları olup mortalite en sık alt uzuv ampütasyonları ile ilişkilidir.
The effect of body mass index on trauma severity and prognosis in trauma patients
(Turkish Assoc Trauma Emergency Surgery, 2016) Durgun, Hasan Mansur; Dursun, Recep; Zengin, Yilmaz; Ozhasenekler, Ayhan; Orak, Murat; Ustundag, Mehmet; Guloglu, Cahfer
BACKGROUND: As in the rest of the world, the prevalence of obesity in Turkey has been increasing in recent years and has become a major public health issue. Although many trials have been conducted to study the effects of obesity on internal diseases, there are few studies investigating the effects of obesity on prognosis of trauma patients. The present study analyzed the effects of body mass index (BMI) on trauma severity and prognosis in trauma patients. METHODS: This study was prospectively conducted with trauma patients older than 15 years of age who presented at the Dicle University Faculty of Medicine emergency medicine department trauma unit between June I, 2013 and May 31, 2014. Patients were grouped into high-energy trauma and low-energy trauma groups based on trauma severity. In addition, 4 groups were made according to BMI value (kg/m(2)). Group I was defined as BMI <25 (normal weight). Group II patients had BMI of 25-29.9 (overweight). Group III had BMI of 30-34.9 (obese), and Group IV was made up of patients with BMI >= 35 (morbidly obese). RESULTS: Comparison of whole patient population for inter-group differences showed significant differences between rate of head injury, thoracic injury, extremity injury, multitrauma, clinic admission rate, and mortality rate (p<0.001). No significant difference was observed between groups in abdominal injury rate (p=0.347). CONCLUSION: Clinic admission rate, length of intensive care unit stay, mortality rate, multitrauma rate, and injury severity score increased in proportion to greater BMI.
Effects of Carvacrol on Experimental Testicular Torsion-Detorsion Model Investigation by Immunohistochemistry
(Sci Printers & Publ Inc, 2020) Dursun, Recep; Sen, Abdullah; Yaman, Mahmut; Durgun, Hasan Mansur; Asir, Firat
OBJECTIVE: To investigate the protective effects of carvacrol on an experimental testicular torsion-detorsion rat model. STUDY DESIGN: Wistar male rats (n=48) weighing 230-250 g were assigned to 4 groups (8 per group): control, torsion, torsion-detorsion, and torsion-detorsion + carvacrol-treated groups. Control group animals did not undergo any surgical operation. For the torsion group, the scrotum was opened (under general anesthesia) and the left testis twisted 720 degrees clockwise and in the last 30 minutes of 3-hour ischemia; i.p. saline was injected. In the torsion-detorsion group, after ischemia the left testis was reperfused for 2 hours. The torsion/ detorsion +carvacrol group protocol was similar to that of the torsion-detorsion group but in the last 30 minutes of 3-hour ischemia, i.p. 20 mg/kg carvacrol was administered. RESULTS: Malondialdehyde (MDA) was highest in the torsion-detorsion group (p <0.01). The lowest catalase (CAT) value was found in the torsion-detorsion group. Decrease in glutathione (GSH) levels of the torsion and torsion-detorsion groups as compared to those of control and carvacrol groups was significant (p<0.01). The highest superoxide dismutase (SOD) value was in the control and carvacrol groups. Increased apoptosis and degeneration of spermatogenic cells with hyperplasic nuclei were mainly observed in the torsion and torsion-detorsion groups. The torsion-detorsion + carvacrol group mostly showed regular histology, but Leydig cells were degenerated. ET-1 expression was increased in endothelial cells in the torsion and detorsion groups but negative in the carvacrol group. Bax expression was positive in luminal spermatogenic cells in the torsion group but negative in interstitial cells in both torsion and torsion-detorsion groups. In the carvacrol-treated group some luminal spermatogenic cells in seminiferous tubules showed positive Bax expression but weak in basal membrane cells and Leydig cells. CONCLUSION: Carvacrol influences spermatogenic cells with strong mitotic activity in basal membranes of seminiferous tubules and may prevent apoptotic development and signaling of these cells.
EFFECTS OF SLEEP QUALITY, INCOME LEVEL AND COMORBID CONDITIONS ON QUALITY OF LIFE IN A TURKISH ELDERLY POPULATION: A MULTICENTRE STUDY
(2015) Selçuk, Engin Burak; Gürbüz, Hüseyin; Zengin, Yılmaz; Durgun, Hasan Mansur; Yeşil, Yusuf; Güllü, Mehmet Nezir; İçer, Mustafa
Giriş: Bu çalışmanın amacı Türk geriatrik popülasyonda uyku kalitesi, gelir durumu ve komorbiditeleri yaşam kalitesine etkisini araştırmaktır.Gereç ve Yöntem: Çalışma İç Hastalıkları ve Geriatri polikliniklerine ayaktan başvuran, 65 yaşüstü 1030 hastayı içeren çok merkezli bir çalışmadır. Hastalarla yapılan yüzyüze görüşme yoluyla Pittsburgh Uyku Kalitesi ve Yaşam Kalitesi Kısa Form (Short Form-36) testleri yapıldı. Görüşmede ayrıca hastaların demografik özellikleri kaydedildi.Bulgular: Uyku kalitesi düşük olan hastaların ortalama yaşam kalitesi subskala skorları (Zindelik skoru hariç) anlamlı olarak daha düşüktü (p<0,001). Çoklu kronik hastalığı olanların yaşamkalitesi 3 parametrede (Fiziksel fonksiyon, Mental sağlık, Ağrı) anlamlı olarak daha düşüktü (sırasıyla p=0,04; p=0,04; p=0,01). İlave olarak gelir durumu iyi olanlarda Fiziksel fonksiyon, Mentalsağlık, Ağrı subskala skor ortalamaları anlamlı olarak daha yüksekti (p=0,01).Sonuç: Çalışma düşük uyku kalitesi, çoklu kronik hastalık varlığı ve düşük gelir durumununyaşam kalitesine olumsuz etkisini ortaya koymuştur
Efficacy of taxifolin in the prevention of renal injury due to liver ischemia and reperfusion
(2023) Ülger, Burak Veli; Durgun, Hasan Mansur; Aşır, Fırat; Varlı, Metin; Gündüz, Ercan
Aim: During surgical procedures such as liver resection and transplantation, ischemia/reperfusion (I/R) injury and related complications may occur at a rate of approximately 10%. Our study, we planned to investigate histologically and biochemically the efficacy of Taxifolin in the prevention of renal tissue damage in liver ischemia reperfusion. Methods: A total of 28 Wistar Albino rats with an average age of 8-10 weeks and weights of 250-300 grams were used in our study. Group 1 (n=7): control group, Group 2 (n=7): Taxifolin group; Taxifolin was administered orally at a dose of 50 mg/kg for 3 weeks, Group 3 (n=7): Liver I/R group, 30 minutes ischemia and 120 minutes reperfusion was performed. Group 4 (n=7): Taxifolin+Liver I/R group. Results: Kidney tissues of the liver I/R group showed atrophy, degeneration of tubule epithelium and increased TNF-? expression. In addition, deterioration in renal function tests was also monitored in this group. In the Taxifolin+Liver I/R group, a significant difference was observed on both histologic and biochemical basis compared to the Liver I/R group and a positive effect was observed (p<0.05). Outcome: As a consequence of hepatic ischemia and reperfusion, impairment in the function and histological appearance of renal tissues was observed and Taxifolin was monitored to be effective in eliminating these adverse effects.
EPIDEMIOLOGICAL CHARACTERISTICS OF GERIATRIC PATIENTS IN EMERGENCY DEPARTMENTS: RESULTS OF A MULTICENTER STUDY
(2015) Avcil, Mücahit; Bayramolu, Atıf; Durgun, Hasan Mansur; Al, Behçet; Yavuz, Yücel; Serinken, Mustafa; Yavafii, Özcan
Girifl: Beklenen yaflam süresinin uzamasının sonucu olarak yafllı popülasyondaki artıfl, bu yaflgrubu için daha sık sağlık bakımı verilmesini zorunlu kılmaktadır. Bu çalıflmada acil servise baflvuran 65 yafl ve üzeri hastaların genel özelliklerini, baflvuru nedenlerini, acil servis ve hastane ziyaretlerinin sonuçlarının saptanması amaçlandı. Gereç ve Yöntem: Çok merkezli, prospektif, gözlemsel çalıflma Türkiye'de 13 hastaneninacil servislerinde bir hafta süre ile gerçekleflti. Çalıflma süresi içinde akut tıbbi veya cerrahi sorunlar ile acil servise baflvuran 65 yafl ve üstü hastalar çalıflmaya dahil edildi. Altmıfl befl yafl altı ve/veya travma nedenli baflvurular ise çalıflma kapsamına alınmadı.Bulgular: Ortalama yaflı 74.8±7.3 yıl olan toplam 1299 hasta çalıflmaya dahil edildi. Bu hastalardan %51.9'u (n=674) 65-74 yafl grubundaydı, %67.5'u (n=877) hastaneden taburcu edildive %5.8'i (n=75) yatıfl süreci içinde öldü. Acil serviste en sık konulan tanılar kardiyovasküler, gastrointestinal ve solunum hastalıklarıydı. Hastaneden taburcu olan ve hastane yatıflı sırasında ölenhasta grupları kıyaslandığında yafl açısından istatistiksel olarak anlamlı fark varken (p=0.001), cinsiyet dağılımı (p=0.259), hastane yatıfl süresi (p=0.259) ve yoğun bakım ünitesi yatıfl süresi(p=0.055) açısından fark tespit edilmedi. Sonuç: Yafllı nüfusunun ve genel nüfusa oranının artıflı ile birlikte yafllı hastaların acil servisbaflvuru sayısı artıyor ve gelecekte daha da artacaktır. Bu çalıflma, çalıflma merkezlerine baflvuranyafllı hastaların demografik özelliklerini ve klinik seyirlerinin sonuçlarını ortaya koymaktadır.
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, Murat
Background: 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.
Evaluation of pregnant patients admitted to the emergency department with suicide attempt
(Modestum Publishing Ltd., 2015) Zengin, Yılmaz; Gündüz, Ercan; Dursun, Recep; İçer, Mustafa; Durgun, Hasan Mansur; Kara, Ertuğrul; Gündüzalp, Ahmet; Güloğlu, Cahfer
Objective: In the pregnancy period, the incidence of suicide attempt is lower compared to other life-periods. However, according to the recent studies, suicide attempts may lead life-threatening consequences in high-risk pregnant women. The aim of this study is to compare pregnant patients admitted to the emergency department for suicide attempt in terms of their sociodemographic and clinical properties and suicide attempt methods. Methods: In this study, 56 patients admitted to the emergency department of university for suicide attempt between January 1, 2009, and December 31, 2014, were included and they were classified according to suicide attempt methods into 2 groups as violent ones. Group 1 included violent methods as hanging, jumping, shooting and Group 2 included non-violent method as drugs. The study was a retrospective cross-sectional study. The sociodemographic, psychiatric and clinical properties of the patients were identified by patient registry system and patient files, and inter-group differences were compared. Results: In this study, 15 (26.7%) patients in the violent suicide attempt group, and 41 (73.3%) patients in the non-violent suicide attempt group, totally 56 patients were included. In the non-violent suicide attempt group, cigarette smoking, suicide attempt due to boredom, and live birth was significantly higher as compared to violent group; hospitalization period and fetal death was lower (p=0.04; p=0.006; p=0.004; p=0.004, respectively). Conclusion: Most of our pregnant suicide attempt patients are in the non-violent group, however, violent suicide attempt increased hospitalization period and fetal mortality significantly. J Clin Exp Invest 2015; 6 (2): 115- 120.
Factors affecting amputations in patients with diabetic foot ulcer referring to the emergency units
(Dicle Üniversitesi Tıp Fakültesi, 2017) İçer, Mustafa; Durgun, Hasan Mansur
Objective: Diabetic foot is the most common cause of lower extremity amputations. The aim of the present study was to investigate the clinical characteristics of and factors affecting amputation in patients with diabetic foot ulcer referring to the emergency units. Methods: The present study was performed based on retrospective review of medical files of 58 patients who were referred to the Emergency Unit of Dicle University, Faculty of Medicine between June 2010 and October 2016 due to diabetic foot ulcer. Results: Of 58 patients included in this study, 31 (53.4%) were men and 27 (46.6%) were women. The mean age was 61.43±11.584 (range: 41 to 85) years. Extremity amputation was not performed in 34 patients (58.6%), while 24 (41.4%) underwent an amputation. Factors affecting extremity amputation were found to be disease duration, presence of coronary artery disease, duration of hospital stay, and presence of osteomyelitis. Among laboratory findings, factors affecting extremity amputation were albumin, hemoglobin, leukocytes, neutrophil, neutrophil/lymphocyte ratio, hemoglobin A1c, and elevated erythrocyte sedimentation rate. The Wagner-Meggitt Classification of Grade 4, University of Texas Classification of stage D and Grade 3 also had significant effects on amputation. (p<0.05) Conclusion: Our study results suggest that together with classification systems, comorbidities, albumin levels, hemoglobin A1c levels, sedimentation rate, and complete blood count results play a key role in predicting the amputation requirement in patients with diabetic foot ulcers referring to the emergency units.
FACTORS AFFECTING MORTALITY IN GERIATRIC PATIENTS WITH HEAD TRAUMA
(Gunes Kitabevi Ltd Sti, 2016) Icer, Mustafa; Sen, Abdullah; Zengin, Yilmaz; Dursun, Recep; Durgun, Hasan Mansur; Ustundag, Mehmet; Orak, Murat
Introduction: With aging, the anatomy and physiology of the body undergo changes. This leads to a change in the body's capabilities in response to trauma, resulting in increased traumainduced morbidity and mortality. We aimed to investigate the factors influencing the prognosis and mortality of geriatric patients with head trauma. Materials and Method: A total of 1060 patients aged 65 and above who presented with head trauma within a three-year period were studied. The patients' collected data included gender, age, trauma presentation, Glasgow Coma Scale, Revised Trauma Score, cranial physical examination findings, localisation of the fracture in the cranial regions, cranial pathology, additional organ injury and survival/death status. Results: Of the 1060 geriatric patients enrolled in the study, 500 (47%) were male and 560 (53%) were female. Of these patients, 1005 (94.8%) survived and 55 (5.20%) died. Among the deceased patients, 37 (37.3%) were male and 18 (32.7%) were female. The most common presentation was observed in the young old group (aged 65-75) with 513 patients. According to the causes of trauma, the most common cause was due to falling. The male gender was found to be at risk of mortality in all patients aged 65 and above. According to the computed tomography findings; intracranial haemorrhage, contusion, subarachnoid haemorrhage, epidural hematoma, subdural hematoma and intracranial edema were factors associated with increased mortality. Conclusion: Males and cranial pathologies are associated with a higher mortality in geriatric patients with head trauma.
FACTORS AFFECTING MORTALITY IN GERIATRICPATIENTS WITH HEAD TRAUMA
(2016) Üstünda, Mehmet; Şen, Abdullah; Dursun, Recep; Orak, Murat; İçer, Mustafa; Güloğlu, Cahfer; Durgun, Hasan Mansur
Girifl:Yaşlılıkla birlikte vücut anatomisinde ve fizyolojisinde değişiklikler olur. Buna bağlı trav-maya karşı cevap yetenekleri değişmekte buda travmaya bağlı morbidite ve mortaliteyi arttırmak-tadır.Geriatrik yaş grubundaki kafa travmalı hastalarda prognoza ve mortaliteye etki eden faktör-leri tespit etmeyi amaçladık.Gereç ve Yöntem:Üç yıllık sürede kafa travması sebebiyle başvurmuş olan 65 yaş ve üstü1060 hasta incelendi. Hasta verileri cinsiyet, yaş, travmanın oluş şekli, Glasgow Koma Skalası, Re-vize Travma Skoru, kraniyal fizik muayene bulguları, kafa kemiklerindeki kırık lokalizasyonu, kra-niyal patoloji, ek organ yaralanması, yaşam ve ölüm durumu idi.Bulgular:Çalışmaya alınan 1060 geriatrik kafa travmalı hastanın 500'ü (%47) erkek, 560'>(%53) bayandı. Hastaların 1005'i (%94.8) yaşadı. Hastaların 55'i (%5.20) öldü. Ölen hastaların37'si (%67.3) erkek, 18'i (%32.7) kadındı. En çok başvuru toplamda 513 hasta ile 65-75 yaş ola-rak tanımlanan erken yaşlılık grubundaydı. Travma oluş sebeplerine göre en sık basit düşme var-dı.65 yaş ve üzeri tüm hasta gruplarında erkek cinsiyette olmanın mortalite için bir risk faktörü ol-duğu görüldü. Bilgisayarl> tomografi görüntülerine göre intrakraniyal kanama, kontüzyon, suba-raknoid hemoraji, epidural hematom, subdural hematom ve intrakraniyal ödem mortaliteyi arttı-ran bulgulardı.Sonuç:Geriatrik kafa travmarında erkek cinsiyet ve kraniyak patolojiler yüksek mortalite ileilişkilidir.

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