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    Geriatric patient crowding in emergency departments
    (2019) Guzel, Murat; Ozgen, Emre; Yucel, Murat; Terzi, Ozlem; Aklar, Ahmet; Ture, Eda; Demir, Mehmet Cihat; Aklar, Ahmet; Baydin, Ahmet
    Aim: An increase in the elderly population owing to an extended average life expectancy leads to an increase in the geriatric patient admissions to the emergency departments (EDs). The aim of this study was to investigate the intensity of geriatric patients among all admissions to the emergency department and to determine the importance of these patients in hospitalizations from the EDs.Material and Methods: Geriatric patients aged over 65 years were retrospectively evaluated between 1 January 2017and 31 December 2018. The patients were divided into two groups by the age: 65–79 (group I) and ≥80 years (group II). The number of days of hospitalization and mortality in the intensive care units (ICUs) and clinics were examined.Results: Of 386.670 patients aged over 18 years who were admitted to the ED, 17% (n=65.907) were aged ≥65 years. 64.4% of the patients who were hospitalized in the ICU from the ED were aged ≥65 years. The sex distribution of the patients who were admitted to but died in the ED in both the groups was as follows: Of 62.1% (n=72) in Group II were females, and of 62.1% (n=82) in Group I were males.Conclusion: In parallel with the increase in the number of geriatric patients in ED, there is a crowding in both clinics and ICUs. This article highlights the importance of geriatric patients in emergency department admissions and their importance in hospitalizations. Hospitalization and mortality rates increase with age. Keywords: Emergency department; crowding; geriatric patients.
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    Relationship between neutrophil-to-lymphocyte ratio, d-dimer and troponin-I values and pulmonary embolism severity index
    (2019) Guzel, Murat; Ozgen, Emre; Terzi, Ozlem; Demir, Mehmet Tevfik; Yucel, Murat; Baydın, Ahmet
    Aim: We aimed to determine whether Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Platelet-toLymphocyte Ratio (PLR), D-dimer, and troponin values were correlated with the simplified Pulmonary Embolism Severity Index (sPESI) in patients diagnosed as having Pulmonary Embolism (PE) in the emergency room. Material and Methods: Forty-three patients diagnosed as having PE in the emergency department were divided into low and highrisk groups according to the sPESI. We investigated whether NLR, MLR, and PLR, d-dimer, troponin-I, and Pulmonary Artery Pressure (PAP) had any effect in determining the severity of PE. Also, patients were divided into groups as those with PAP ≤20 or >20 mm Hg, Systolic Blood Pressure (SBP) ≤100 or >100 mm Hg, and those receiving or not receiving thrombolytic treatment, and compared. Results: There was a statistically significant difference between patients with low sPESI (n=10) and those with high sPESI (n=33) in terms of age (p=0.001), pulse (p=0.016), oxygen saturation (p=0.039), troponin-I (p=0.029) and PAP (p=0.032), but there was no difference between the groups in terms of NLR (p=0.796), MLR (p=0.656), PLR (p=0.863), and d-dimer (p=0.343). There was a statistically significant difference between patients who did (n=6) and did not (n=37) receive thrombolytic treatment in terms of troponin-I (p=0.012), but there was no difference between the groups in terms of NLR (p=0.861), MLR (p=0.335), and PLR (p=0.277). Conclusion: NLR, MLR, PLR and d-dimer levels were found not to be effective in determining the severity of PE. Troponin-I was associated with sPESI and was considered as an effective marker in determining the thrombolytic treatment.