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    Characteristics of the admissions of cancer patients to emergency department
    (Zerbinis Medical Publ, 2012) Yucel, N.; Erkal, H. Sukru; Akgun, F. Sinem; Serin, M.
    Purpose: To identify the characteristics of admission of patients with cancer in the emergency department of a university hospital. Methods: The medical records of 468 emergency department admissions of 336 cancer patients due to medical conditions that were related either to their cancer or its treatment were reviewed and retrospectively analysed. Results: There were 226(67%) males and 110 females (37%), with a median age of 60 years (range 17-93). Regarding cancer staging, 156 (46%) patients had locoregional disease and 180 (54%) metastatic disease. Regarding performance status (PS), 321 (69%) were Eastern Cooperative Oncology Group (ECOG) 1-2, and 147 (31%) were ECOG 3-4. The main causes of emergency department admission were cancer progression in 188 (40%) patients, cancer-related signs and symptoms in 203 (43%) and treatment-related complications in 77 (16%). The most common primary cancer sites were the thorax, the gastrointestinal system and the genitourinary system. The medical condition necessitating emergency department admission was local tumor compression in 144 (31%) admissions, infection in 86 (19%) and end-of-life support in 63 (13%). Conclusion: Cancer patients seeking nonscheduled medical care and admitting to emergency departments present many challenges to the emergency physician. Due to the associated high morbidity and mortality, initial evaluation of the patient in the emergency department and therapy have utmost importance in the outcome of the patient. Accurate diagnosis and appropriate treatment of cancer-related problems can improve the quality of life dramatically in patients with cancer.
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    Retrospective Analysis of Intoxication Patients Admitted to Intensive Care Unit: Evidence Based Management vs Personal Experience
    (Drunpp-Sarajevo, 2011) Ertan, Cem; Gedik, Ender; Yucel, Neslihan; Akgun, F. Sinem; Aslan, Sibel; Togal, Turkan; Ersoy, M. Ozcan
    Objective: Intoxication is a major problem in emergency departments (ED). Patients shall either be hospitalized or discharged after ED care. This decision requires a thorough evaluation of the patients' risk of mortality and cost effective approach. Aim of this study was to define characteristics of our poisoning patients and appropriateness of their hospitalization decisions to ICU. Methods: Adult patients hospitalized to ICU following admittance to ED within three years period with acute poisoning were retrospectively enrolled. Demographics, poisoning data, former psychiatric history, ICU follow up information, outcome at hospital discharge and in the first 28 days and predominant pathological clinical findings were recorded. Results: Our study group accounted for 3.6 per 1000 ED visits and 16.6% of ICU admittance. Mean age of the patients was 30.21 +/- 12.83 years, F/M ratio was 2.2 and 48.9% of the patients were married. Foremost encountered substances were psychoactive drugs (39.4%). 94.2% of our patients were suicidal and 39.8% of them used two or more agents. Intubation and mechanical ventilation was performed for 14 patients (5.1%), mean duration for intubated follow up was 7.07 days. Only two patients with caustic ingestions were dead (0.8%). Mean hospitalization period was 4.78 +/- 8.77 days and mean ICU bed use was 2.62 +/- 3.18 days. Total hospitalization duration was <= 48 hours 198 (72.3%) patients and > 48 hours in 76 patients (27.7%). Conclusion: We speculate that, high rates of early discharge from ICU may support the necessity of a solid ICU admission criterion.