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    Evaluation of incidental findings of whole body computed tomography in multiple trauma patients in emergency department
    (2019) Bedel, Cihan; Korkut, Mustafa; Erman, Kursat
    Aim: The aim of this study was to investigate the frequency of incidental findings and the clinically significant ones in whole-body computed tomography (WBCT) scans in multiple trauma patients in the emergency department (ED). Material and Methods: This study was designed as a single-centered retrospective cohort in a tertiary emergency room. Multiple trauma patients who were screened with WBCT in the ED in 2017 were analyzed. Incidental findings (IF) were categorized into 3 groups as group 1 (emergency treatment / need further examination), group 2 (need examination depending on the symptoms of patients) and group 3 (minor findings with no need for further examination). Results: WBCT screening was performed in 206 of 3746 patients (5.4%) who were admitted to the trauma unit in ED due to multiple traumas. A total of 360 IFs were found in 138 (67%) of 206 patients. Of the patients, 13.3% were classified as group 1, 30.9% as group 2, 55.8% as group 3 and IF was detected, respectively (48, 111, 201). Cardiomegaly was the most common finding in group 1 (n = 11). In group 2, hepatomegaly (n = 18) and atherosclerosis (n = 13) were the most common ones observed. Brain calcifications (n = 42) and renal cysts (n = 17) were the most common findings in Group 3. The age distribution of patients with IF was statistically significantly higher compared to those without IF (43.54 ± 18.78, 25.16 ± 11.7, p <0.001, respectively). Conclusion: WBCT is used in the ED with an increasing frequency in multiple trauma patients and causes incidental findings to occur significantly. Some of these findings may be vital and may require further clinical evaluation and follow-up.
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    The value of ultra-sensitive troponin I in determining the prognosis of patients with the suspected acute coronary syndrome in the emergency department
    (2021) Unal, Osman Gursoy; Korkut, Mustafa; Yuruktumen Unal, Aslihan; Bedel, Cihan; Yildiz, Manolya
    Aim: Acute coronary syndromes (ACS) have significant mortality and morbidity in our country and the world. With the development of technology, early diagnosis and treatment may be possible. Ultra-sensitive troponin I (us-TnI) test developed a few years ago has provided accurate detection of even lower troponin concentrations using a microparticle immunoassay. There are very few studies in the literature about us-TnI showing prognosis. In this study, we aimed to find the value of the newly introduced us-TnI in determining mortality in one-month and three-month follow-ups. Materials and Methods: The study included all patients who were admitted to our tertiary emergency department (ED) between November 2015 and June 2016 and whose us-TnI levels was studied considering ACS. Whether the follow-up of the patients included in the study resulted in death was determined. The patients were classified according to the date of death based on their mortality status at the end of the first month and third month. Results: It was found that of the patients, 4.0% (n=264) died within 1 month after the first troponin measurement, while 6.8% (n=444) died within 3 months after the first troponin measurement. The AUC of the baseline us-TnI value in determining cardiac death at the end of the first month was 0.803 (95% Cl: 0.793-0.813) and the AUC of the baseline us-TnI value in determining cardiac death at the end of the third month was 0.763 (95% Cl: 0.752-0.773). Conclusion: Us-TnI studied at the time of admission to ED is an early indicator of mortality in patients with the diagnosis of ACS.