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    Clinical features and predisposing factors of delirium due to COVID-19 pneumonia in intensive care units
    (Verduci Publisher, 2022) Ekmekyapar, T.; Ekmekyapar, M.; Tasci, I; Sahin, L.; Delen, L. A.
    OBJECTIVE: Delirium is an acute disorder in which attention, perception, memory, thought, mood, psychomotor activity and sleep-wake cycles change rapidly. Delirium is also a common clinical syndrome in patients hospitalized in intensive care units due to COVID-19 pneumonia. We reviewed clinical features and predisposing factors of delirium according to psychomotor subtype in patients hospitalized in the intensive care units due to COVID-19 pneumonia. PATIENTS AND METHODS: 64 patients who were hospitalized in the intensive care units due to COVID-19 pneumonia were included. Delirium status and psychomotor subtype were determined by applying the Confusion Assessment Method for the Intensive Care Unit scale to the patients daily. The gender, age, comorbidity, treatments, intubation, and mortality rates of the patients were recorded. Multivariate analyses were performed by examining predisposing factors. arterial blood gases, hemograms, biochemistry, and brain magnetic resonance imaging. RESULTS: There were 64 patients in delirium clinic, 65.6% (n=42) of them were male. Hypokinetic delirium was more common in 60.9% (n=39). 79.4% of the patients who received ventilator support were male (p=0.013). When mortality was analyzed in this group, hypoactive delirium was found to be significantly higher (p=0.035). In addition, leukocyte levels were higher in patients with hypokinetic delirium (p=0.029). Ferritin and fibrinogen levels were higher in patients with hyperkinetic delirium (p=0.039, p=0.008, respectively). CONCLUSIONS: The presence of additional diseases such as advanced age, male gender, hypertension, coronary artery disease, dementia, and hypoxia were factors that increased the frequency of delirium. In addition, the mortality rate was higher in patients with hypokinetic delirium.
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    A comparison of computerized tomography and flair-SWI MRI results of patients with head injury attending the emergency department
    (Verduci Publisher, 2022) Durak, M. A.; Gurbuez, S.; Derya, S.; Yildirim, I. o.; Ekmekyapar, M.; Tetik, B.; Colak, C.
    - OBJECTIVE: Detection of trau-matic brain injury (TBI) is of vital importance in patients who apply to the emergency depart-ment with a history of trauma. The aim of initial imaging in patients with suspected TBI is to de-tect trauma-related injury quickly and accurate-ly. In this study, the effectiveness of prospec-tively cranial computed tomography (CT) and fluid attenuation inversion recovery (FLAIR) and susceptibility weighted imaging (SWI) sequence magnetic resonance imaging (MRI) examination results of patients diagnosed with TBI in the emergency department in terms of bleeding de-tection was investigated in the light of the liter-ature. PATIENTS AND METHODS: Patients with traumatic brain injury who applied to the emer-gency department between 2016 and 2020 were included in this prospective study. Crani-al CT and MRI images containing SWI-FLAIR se-quence were taken on the same day, immediate-ly after cranial CT, for a total of 500 patients. RESULTS: In our study, TBI was detected in 242 males (70.8%) and 100 females (29.2%), for a total of 342 patients. The mean age was 41.45, the mean GCS was 13.35. There was a history of trauma such as falling in 155 patients (45.3%), traffic accidents in 171 patients (50%), and trau-ma in 16 patients (4.7%). In the comparative eval-uation of CT and FLAIR-SWI MRI examinations no bleeding was detected in the FLAIR-SWI sec-tions of 239 patients who did not have bleed-ing on CT; however, bleeding was detected in FLAIR-SWI sections in 14 patients who did not have bleeding on CT. CONCLUSIONS: FLAIR-SWI MR, which is a more reliable examination method, should be per-formed before control CT, especially in patients with incompatible clinical and admission CT.
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    Nutritional evaluation of non-traumatic patients admitted to the hospital from Emergency Department
    (Verduci Publisher, 2022) Gurbuz, S.; Ekmekyapar, M.; Durak, M. A.; Oguzturk, H.; Turtay, M. G.; Yucel, N.; Demir, T. O.
    OBJECTIVE: Malnutrition is a common condition, especially among hospitalized patients which are overlooked by many clinicians. Malnutrition was found to be associated with increased hospitalization duration, increased admission frequency. increase in infection frequency and severity, bad wound healing, gait disturbances, fallings. and fractures. In this study, we aimed to determine malnutrition frequency in patients who were admitted to the emergency department for non-trauma causes and hospitalized. PATIENTS AND METHODS: 245 patients were admitted to the Emergency Department for non-trauma causes and hospitalized and 245 control group patients were included in this study. Hospitalized patients were assessed with NRS-2002 (Nutritional Risk Screening) and Mini Nutritional Assessment (MNA). Age, gender. height. weight, body mass index (BMI), malnutrition status. and wards of the patients were screened. RESULTS: 140 (57.1%) of the hospitalized patients had malnutrition according to NRS-2002 and MNA. There was a statistically significant difference between the control group and the hospitalized patients who were malnourished (Pearson chi-square test: p<0,001). There was a significant relation between hospitalized departments and malnutrition (p<0.05). There was a significant difference in age and height between hospitalized patients and the control group (p<0.0001) whereas no significant difference was found between the height and BMI (p>0.05). There was a significant relationship in terms of hospitalization and malnutrition. CONCLUSIONS: The nutritional state of the patients admitted to the emergency department for non-trauma conditions is an important factor and should not be overlooked.