Przeglądanie według Temat "emergency department"

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Comparison of falls and non-fall admissions to the emergency department in older adults and evaluation of the Barthel index and the Falls Efficacy Scale International scores
(Rzeszów University Press, 2025-03) Keskin, Sevgi; Altunci, Yusuf Ali; Kodik, Meltem Songür; Akarca, Funda Karbek
Introduction and aim. The aim of this study was to describe the characteristics of patients aged 65 years and older who expe rienced falls and to examine the distribution of the Barthel index (BI) and Falls Efficacy Scale International (FES-I) scores. Material and methods. Participants over 65 years of age who were admitted to the emergency department (ED) between 31.07.2019 and 31.01.2020 and who met the inclusion criteria were included in the study. Characteristics, BI, and FES-I scores of patients admitted to the emergency department for falls and nontraumatic reasons were compared. Results. The study was carried out with 259 participants, 133 in the fall group and 126 in the control group. The mean age was 79±8.3 years in the fall group and 76.3±7.9 years in the control group (p=0.011). In the fall group, 61 (46.2%) were male and 71 (53.8%) were females. The most common trauma after a fall was soft tissue trauma. The FES-I and BI scores were found to be at higher risk in the fall group aged 75-84 years compared to the control group and there was a statistically significant difference between them (p=0.009; p=0.030, respectively). Conclusion. FES-I and BI did not show significant differences between fall and control groups in all age groups. In the 75-84 age group, both scales showed higher values in the fall group. We believe these scales can be used as follow-up tools in screening and preventing fall risks, especially in this age group.
Fall risk and frailty level in older adults admitted to the emergency department with a complaint of falling
(Publishing Office of the University of Rzeszow, 2023-12) Çelik, Sevim; Uğur, Neşe; Karahan, Elif; Dolu, İlknur
Introduction and aim. Falls are the second leading cause of unintentional death in the world. The study was conducted to examine the risk of falls and levels of frailty in older adult patients admitted to the emergency department due to fractures, as well as to identify the factors that influence fall risk and frailty levels. Material and methods. This cross-sectional and correlational study conducted with 155 older patients. Data collected by the patient information form, Itaki Fall Risk Scale and Edmonton Frail Scale. Results. Patients diagnosed with fracture in the emergency department had a high risk of falling with a mean score of 9.55±3.84.70.3% of the patients were frail. The one-third (30.3%) had severe frailty. There was a moderate positive correlation between the risk of falling and the mean frailty score of the older adult patients (p<0.001). Conclusion. The study showed that older adults admitted to the emergency department due to falls are at high risk of falling and the majority of them are frail. Early determination of fall risk and frailty levels in the older adults with a history of falling, prevention of falls and fractures due to falls will be beneficial in increasing the quality of life of the older adults.
Novaluron and indoxacarb induced methemoglobinemia – unveiling a rare poisoning
(Publishing Office of the University of Rzeszow, 2024-06) Shaji, Ijas Muhammed; Mohanty, Chitta Ranjan; Radhakrishnan, Rakesh Vadakkethil; Siddique, Ruby Nahan
Introduction and aim. In India, the utilization of agricultural pesticides for intentional self-poisoning is a prevalent method, and it is associated with substantially higher fatality rates compared to other self-poisoning approaches. Plethora, an agricultural insecticide containing novaluron (5.25%) and indoxacarb (4.5%), has recently been introduced and widely used in India and various other regions for its broad-spectrum lepidopteran control. While there have been documented cases of isolated self-poisoning involving indoxacarb, there is currently no literature reporting incidents of human poisoning specifically related to novaluron. Description of the case. An 83-Year-old male was presented to the emergency department (ED) with a history of consumption of 50 mL of an insecticide suspension concentrate called ‘PLETHORA’ to commit suicide. He had one episode of vomiting and dizziness after the ingestion. There was associated cyanosis, and the patient was put on high-flow oxygen at 10 L/min through a face mask. The patient was diagnosed to have methemoglobinemia and was successfully treated with methylene blue and ascorbic acid. One hour post methylene blue injection showed a methemoglobin level of 1%, and the patient gradually improved. Patients presenting with novaluron and indoxacarb poisoning require supportive treatment as there is no specific antidote. There should be a high index of suspicion for methemoglobinemia in such patients, and timely management is necessary to prevent further complications. The patient was successfully managed and discharged after the 3rd day of admission. Conclusion. The management of patients with novaluron and indoxacarb poisoning primarily involves supportive care, as there is currently no specific antidote available for these substances. Maintaining a high suspicion index for the development of methemoglobinemia and timely management of other complications is crucial for the best possible patient outcomes.
Predictors of hospitalization in patients presenting to emergency department with an acute exacerbation of COPD – a single-center study in Turkey
(Publishing Office of the University of Rzeszow, 2023-09) Sanalp Menekşe, Tuğba; Sert, Ekrem Taha
Introduction and aim. In this study, we evaluated parameters that might be associated with hospitalization in patients admitted to the emergency department (ED) with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Material and methods. Patients with COPD who presented to ED due to AECOPD between January 1, 2020 and December 31, 2021 were included in the study. Patient data were obtained from the hospital database. Univariable and multivariable logistic regression methods were used to identify the relationship between hospitalization and clinical parameters. Results. The study included 237 patients divided into two groups: inpatients (n=124) and outpatients (n=113). We found significant differences between the two groups in terms of temperature, oxygen saturation, respiratory rate, C-reactive protein, white blood cell count, procalcitonin, albumin, arterial blood pH, pCO 2 , and non-invasive mechanical ventilation (NIMV) requirement. Multivariable logistic regression analysis showed that body temperature [odds ratio (OR):1.62;95% confidence interval (CI):1.21–4.91; p<0.001], oxygen saturation (OR:0.73, 95% CI:0.39-0.94, p<0.001), respiratory rate (OR:1.96; 95% CI: 1.07–6.14; p<0.001), albumin (OR:0.71; 95% CI:0.41–0.93; p=0.042), procalcitonin (OR:2.93; 95% CI:1.22–4.84; p<0.001), arterial blood pH (OR:0.78; 95% CI:0.29-0.91; p=0.038), pCO 2 (OR:2.45; 95% CI:1.24–4.65; p<0.001), and NIMV requirement (OR:2.31; 95% CI:1.41–5.13; p<0.001) were the independent predictors of hospitalization. Conclusion. Our findings may help identify patients who will require hospitalization at an early stage.
The relationship of biochemical parameters and radiological parameters in the evaluation of the clinical severity of acute pancreatitis in the emergency department – a retrospective analysis
(Publishing Office of the University of Rzeszow, 2023-06) Tortum, Fatma; Tekin, Erdal; Aydın, Fahri; Özdal, Emine; Tatlısu, Kübra
Introduction and aim. Computed tomography severity index (CTSI) and Balthazar score are among the most frequently used scorings in the determination of severe acute pancreatitis. The primary purpose of this study is evaluation of the effects of biochemical parameters, Balthazar score and CTSI on mortality in acute pancreatitis. At the same time, correlations with biochemical parameters, CTSI and Balthazar score were evaluated in patients with AP. Material and methods. In this study, the amylase, lipase, CRP, and procalcitonin values of patients diagnosed with acute pancreatitis were retrospectively recorded. Contrast-enhanced computed tomography (CECT) images obtained at the time of presentation to the emergency department or within seven days of admission were re-evaluated by two radiologists. The CTSI scores and Balthazar scores of the patients were calculated. Results. The study included 240 patients. The amylase level of the patients was positively correlated with the Balthazar score at a statistically significant level (R=0.189, p=0.003). In addition,, the relationship between pancreatic scoring systems and mortality, the AUC value for CTSI was 0.9 (95% CI: 0.826-0.973) and was higher than other scoring systems. Conclusion. CTSI had better performance in the prediction of mortality in patients with acute pancreatitis.