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Öğe Acil servise diş ve diş eti rahatsızlığı nedeniyle başvuran hastaların değerlendirilmesi(2005) Söyüncü, S.; Oktay, C; Ertan, C.; Eken, C.; Janitzky, A. A.Öz: Giriş: Komplike olmayan diş ve diş eti rahatsızlığı olan hastalar acil servis başvurularının önemli bir kısmını oluşturmaktadır. Bu çalışmanın amacı acil servise diş ve diş eti yakınmasıyla başvuran hastaların demografik özelliklerini saptamak ve bu hastalara acil serviste yapılan uygulamaları belirlemektir. Gereç ve Yöntem: Geriye dönük olarak yapılan çalışmada 2001 Temmuz ile 2004 Eylül tarihleri arasında acil servise diş ve diş eti yakınmasıyla başvuran 303 hastanın verilerine hastane kayıt sisteminden ulaşıldı. 15 yaş altı travma dışı dental problemi olan hastalar çalışmadan dışlandı. Hastaların demografik özellikleri, acil servis başvuru gün ve saatleri, ICD-10 tanı kodları ve acil serviste hastalara verilen tedaviler ile ilgili bilgiler toplanarak hastaların demografik özellikleri tanımlandı. Bulgular: Diş ve diş eti yakınmasıyla acil servise başvuran 303 hastanın verileri değerlendirildi. Çalışmaya alınan hastaların 155'i (%51,2) erkekti. Hastaların yaş ortalaması 34±15 (minimum 1, maksimum 80) olup, hastaların 116'sı (%38,3) 16-25 yaş grubunda idi. ICD-10 tanı koduna göre hastaların 192'sini (%63,4) 'gingivit ve periodontal hastalıklar' tanısını alanlar oluşturuyordu. Hastaların 148'ine (%52) analjezik, 24'üne (%8) antibiyotik tedavisi verildi. Diş hekimlerinin kapalı olduğu saatlerde acil servise başvuran hasta sayısı 248'di (%82). Sonuç: Acil servisler diş ve diş eti yakınmaları olan hastalar için önemli bir başvuru alanıdır. Bu nedenle acil servislerde diş acillerinin tanı, basit tedavi ve daha sonraki takipleri yapılabilmelidir. Bunun için acil tıp uzmanlığı veren kurumların asistan eğitim programlarında diş ve diş eti hastalıkları konusunda yeterli eğitim süresi ayrılmalı ve bu hastaların hasta bakım kalitesi arttırılmaya çalışılmalıdır.Öğe COUGH AND DYSPNEA: REMINDING A SOMEWHAT UNRECOGNIZED DIAGNOSE(Aves, 2008) Ertan, C.; Tekin, Y. K.; Ertan, D.Shortness of breath is one of the most common and most critical causes of the emergency department visits. Although the most common etiologies of shortness of breath are cardiac and pulmonary diseases, other serious secondary reasons should not be avoided. Either previously diagnosed or not, chronic renal failure is one of the most important secondary causes. Shortness of breath and cough may be the only symptoms at presentation. We will discuss a patient admitting to our emergency department alone with cough and dyspnea and ended up with the diagnosis of uremic lung and chronic renal failure.Öğe Predictors of mortality in septic shock: findings for 57 patients diagnosed on admission to emergency or within 24 hours of admission to intensive care(Sage Publications Ltd, 2012) Yucel, N.; Togal, T.; Gedik, E.; Ertan, C.; Kayabas, U.; Akgun, F. S.; Bayindir, Y.Objective: To identify the risk factors that influence outcome for patients who are diagnosed with septic shock in the emergency department at presentation or within 24 hours after admission to intensive care unit. Methods: A retrospective study of 57 adult patients with septic shock was conducted between March 1, 2006 and August 31, 2009. Results: The patients were 23 males and 34 females with a median age of 67 years (20 to 92 years). Thirty-three (58%) of 57 patients died in hospital and 24 (42%) survived. Multivariate analysis identified low blood pH (OR <0.001; 95% CI <0.001-0.53) and low bicarbonate level (OR 0.81; 95% CI 0.70-0.95) at emergency department or intensive care unit admission as useful predictors of 3-day in-hospital mortality. Low blood pH (OR <0.001; 95% CI <0.001-0.05), low bicarbonate level (OR 0.75; 95% CIs 0.61-0.91), long duration of symptoms (OR 1.49; 95% CI 1.04-2.13), high MEDS score (OR 1.56; 95% CIs 1.06-2.30), and high SOFA score (OR 1.57; 95% CI 1.12-2.20) were risk factors for 14-day in-hospital mortality. Renal failure (OR 7.58; 95% CI 1.28-44.77), lower pulmonary tract infection (OR 3.58; 95% CI 1.10-11.58), high MEDS score (OR 1.42; 95% CI 1.05-1.93) and high APACHE II score (OR 1.34; 95% CI 1.13-1.60) were risk factors for 28-day in-hospital mortality. Conclusions: Several factors signaling poor short-term outcome for this patient group are low blood pH, low serum bicarbonate level, longer duration of symptoms lower respiratory tract infection and renal failure. MEDS and SOFA scores might be helpful in the ED to stratify patients with septic shock according to mortality risk. (Hong Kong j. emerg.med. 2012;19:375-386)Öğe The prognastic efficiencies of modified early warning score and mainz emergency evaluation score for emergency department patients(Nıgerıan journal of clınıcal practıce, 2018) Akgun, F. S.; Ertan, C.; Yucel, N.Background: Recently, there is an increasing interest for scoring systems to evaluate the critically ill patients by means of the severeness of their disease and their availibility for discharge in the emergency departments and intensive care units. Our aim in this study is to evaluate the efficiency of the mEWS and MEES scoring systems in assessing the severeness of the disease and predicting the mid term prognosis of the patients hospitalized following their emergency care in our emergency room. Material and Method: Patients, who attended to Inonu University Department of Emergency Medicine and hospitalized following their emergency care were included to our study. The effects of age, sex, triage categories, mEWS and MEES scores on the site of hospitalization and mortality was evaluated. Statistical analyses were performed by SPSS for Windows version 16.0. The data was summarized as means, standart deviation and percents. Univariate and multiavriate analyses were performed for risk factor calculations. Results: The mean age of the patients was 5819 and 584 (56%) were male. Triage group 1 patients accounted for 21 of all (2%), while 646 (61%) were in group 2 and 384 (37%) were in triage group 3. Of all patients, 341 (32%) were hospitalized to ICU. While discharged patients accounted for 89% (935 patients) of the study group, 116 patients (11%) died at the hospital. The GCS, AVPU and mEWS values were statistically significant by means of patient mortality (P < 0.0001), but the delta MEES value was not (P < 0.127). Conclusion: The results of our stuy suggests that mEWS evaluation is an effective and reliable tool for predicting outcome and hospitalization areas of ED patients. Our results also displayed that the easily available GCS and AVPU scales are reliable guides in patient management. MEES values, on the other hand, are not convenient for ED use.Öğe The prognastic efficiencies of modified early warning score and mainz emergency evaluation score for emergency department patients(Wolters Kluwer Medknow Publications, 2018) Akgun, F. S.; Ertan, C.; Yucel, N.Background: Recently, there is an increasing interest for scoring systems to evaluate the critically ill patients by means of the severeness of their disease and their availibility for discharge in the emergency departments and intensive care units. Our aim in this study is to evaluate the efficiency of the mEWS and MEES scoring systems in assessing the severeness of the disease and predicting the mid term prognosis of the patients hospitalized following their emergency care in our emergency room. Material and Method: Patients, who attended to Inonu University Department of Emergency Medicine and hospitalized following their emergency care were included to our study. The effects of age, sex, triage categories, mEWS and MEES scores on the site of hospitalization and mortality was evaluated. Statistical analyses were performed by SPSS for Windows version 16.0. The data was summarized as means, standart deviation and percents. Univariate and multiavriate analyses were performed for risk factor calculations. Results: The mean age of the patients was 5819 and 584 (56%) were male. Triage group 1 patients accounted for 21 of all (2%), while 646 (61%) were in group 2 and 384 (37%) were in triage group 3. Of all patients, 341 (32%) were hospitalized to ICU. While discharged patients accounted for 89% (935 patients) of the study group, 116 patients (11%) died at the hospital. The GCS, AVPU and mEWS values were statistically significant by means of patient mortality (P < 0.0001), but the delta MEES value was not (P < 0.127). Conclusion: The results of our stuy suggests that mEWS evaluation is an effective and reliable tool for predicting outcome and hospitalization areas of ED patients. Our results also displayed that the easily available GCS and AVPU scales are reliable guides in patient management. MEES values, on the other hand, are not convenient for ED use.Öğe The prognastic efficiencies of modified early warning score and mainzemergency evaluation score for emergency department patients(Wolters kluwer medknow publıcatıons, wolters kluwer ındıa pvt ltd , a-202, 2nd flr, qube, c t s no 1498a-2 vıllage marol, andherı east, mumbaı, 400059, ındıa, 2018) Akgun, F. S.; Ertan, C.; Yucel, N.Background: Recently, there is an increasing interest for scoring systems to evaluate the critically ill patients by means of the severeness of their disease and their availibility for discharge in the emergency departments and intensive care units. Our aim in this study is to evaluate the efficiency of the mEWS and MEES scoring systems in assessing the severeness of the disease and predicting the mid term prognosis of the patients hospitalized following their emergency care in our emergency room. Material and Method: Patients, who attended to Inonu University Department of Emergency Medicine and hospitalized following their emergency care were included to our study. The effects of age, sex, triage categories, mEWS and MEES scores on the site of hospitalization and mortality was evaluated. Statistical analyses were performed by SPSS for Windows version 16.0. The data was summarized as means, standart deviation and percents. Univariate and multiavriate analyses were performed for risk factor calculations. Results: The mean age of the patients was 5819 and 584 (56%) were male. Triage group 1 patients accounted for 21 of all (2%), while 646 (61%) were in group 2 and 384 (37%) were in triage group 3. Of all patients, 341 (32%) were hospitalized to ICU. While discharged patients accounted for 89% (935 patients) of the study group, 116 patients (11%) died at the hospital. The GCS, AVPU and mEWS values were statistically significant by means of patient mortality (P < 0.0001), but the delta MEES value was not (P < 0.127). Conclusion: The results of our stuy suggests that mEWS evaluation is an effective and reliable tool for predicting outcome and hospitalization areas of ED patients. Our results also displayed that the easily available GCS and AVPU scales are reliable guides in patient management. MEES values, on the other hand, are not convenient for ED use.Öğe The prognostic values of the admission electrocardiography, myocardial injury markers and physical examination in patients with acute myocardial infarction(Sage Publications Ltd, 2011) Ertan, C.; Cete, Y.; Kilicaslan, I.; Goksu, E.; Kanalici, H.Introduction: Acute coronary syndromes (ACS) are leading life threatening causes of chest pain, which is one of the most common complaints in the emergency department (ED). The aim of the study was to demonstrate the usefulness of physical examination, ECG and cardiac markers to predict short term outcome of ACS patients. Methods: A total of 1728 patients with chest pain were evaluated between 1st January 2003 and 31st December 2003 in the ED and 236 of the patients matched our study criteria. Results: In the study group 184 patients were (78%) male and the mean age was 59.8 +/- 12.2 (range=4-92) years old. Age, Killip score, cardiac marker values, the time interval between the beginning of the chest pain and ED entry and the ECG changes were the studied variables. With the logistic regression analysis, Killip score and any rhythm other than normal sinus rhythm on the first ECG were found to be the only independent variables to predict early mortality (p=0.036 and p=0.033). Conclusion: Simple measures in the ED such as ECG and serum markers of myocardial injury along with the thorough physical evaluation of the physician may predict early negative outcome. (Hong Kong j.emerg.med. 2011;18:294-299)
