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    Analysis of non-traumatic elderly patient presentations to the emergency department [Acil servise başvuran travma dişi geriatrik olgularin demografik özelliklerinin incelenmesi]
    (2013) Logoglu A.; Ayrik C.; Köse A.; Bozkurt S.; Demir F.; Narci H.; Karaaslan U.
    Objectives: We aimed to investigate the demographic and clinical outcomes of elderly patients that presented to the emergency department (ED). Methods: Patients that were 65 years and older that presented to the Mersin University Medicine Faculty ED between December 1, 2011 and November 30, 2012 made up the study sample. From this pool of potential study subjects, trauma patients were excluded and then 10% of the remaining patients were randomly selected to form the final study sample. A retrospective chart review was performed. Results: A total of 949 elderly ED patients were studied of which 53.7% were between the ages of 65 to 74 years, 37.6% were 75 to 84 years, and 8.6% were 85 years and older. Compared to elderly patients that were 85 years and older, patients in the 65-74 years and 75-84 years age groups both had significantly greater usage of antiplatelet drugs (p=0.029) and medications that treat neurological disorders (p=0.014). From the ED, cardiology was the most commonly consulted at 15.2% followed by internal medicine at 13.7% and pulmonary medicine at 7.4%. Moreover, the number of consultations significantly increased with older age (p=0.003). For elderly patients that were discharged, the average length of stay in the ED was 162.7 minutes, whereas patients that were admitted into the hospital stayed in the ED over an average of 220.6 minutes (p<0.001). Patients 85 years and older that were admitted into the hospital from the ED were found to have a hospital stay that was 4 ± 6.6 days longer than the other age groups (p<0.001). Conclusions: Elderly patients presenting to the ED tend to be medically complicated, and so it is imperative that health providers are adequately trained and experienced in delivering medical care to geriatric populations.
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    Predictive calue of leucocyte count, neutrophil percent and C-reactive protein concentration “cut-off value” on the diagnosis of appendicitis [Lökosit sayısı, yüzde nötrofil oranı ve C-reaktif protein konsantrasyonlarının “kesim değeri” düzeylerinde apandisit tanısındaki değerleri]
    (Turkish Association of Trauma and Emergency Surgery, 2016) Ayrık C.; Karaaslan U.; Dağ A.; Bozkurt S.; Toker İ.; Demir F.
    BACKGROUND: The present study aimed to investigate the predictive importance of cut-off levels of preoperative WBC, neutrophil and CRP concentrations in operated appendicitis patients. METHODS: Patients operated for acute appendicitis between January 2008 and November 2010 were retrospectively screened. Patients were divided into three groups according to postoperative histopathology. Group I: normal appendix, Group II: Uncomplicated appendicitis, Group III: complicated appendicitis. ROC curves are intended for positive distinguishing pathological laboratory measurements. Cut-off values were determined and distinguishing performances were assessed. RESULTS: 175 of the 320 patients were males (54.7%) and 145 were females (45.3%). Average age was 35.95±14.75. While cut-off value for WBC was 12.080 and it was found significant in distinguishing total appandisitis (group II+group III) from normal appendixes and distinguishing group II from group I (p<0.001), it was determined that it was not significant in distinguishing group II from group III (p=0.768). While cut-off value for neutrophil was 73% and it was significant in distinguishing group II+group III from group I and group II from group I (p<0.001), it was detected that it was not significant in distinguishing group II from group III (p=0.681). While cut-off value for CRP was 45.98, it was not found significant in distinguishing group II+group III from group I and group II from group I; however it was significant in distinguishing group II from group III (p<0.001). When all measurements were evaluated together, it was detected that the increase in only the neutrophil percentage rised the non-complicated acute appendisitis (OR: 1.082; p<0.001), and the increase in both neutrophiles and CRP resulted in a rise in the risk of complication (OR: neutrophil= 1.066; p=0.009- CRP=1.005; p=0.013). DISCUSSION: The cut-off value of labaratuary tests may help determine the diagnosis and treatment. Especially, cut-off value of CRP may be helpful to determine the method of incision during the operation as conventional appendectomy or laparoscopic appendectomy. © 2016 TJTES.