Nuray Aslan

Background: This study aimed to compare the emergency department (ED) and intensive care unit (ICU) admission processes of the local population and individuals with migrant, refugee, or asylum status as well as to evaluate differences between the groups. Methods: This retrospective observational study was conducted by analyzing the data of 10,163 patients who presented to the Emergency Medicine Clinic of Sakarya Training and Research Hospital between 1 January 2022 and 1 January 2024, and were determined to require ICU care. Among these, 10,060 were from the local population and 103 were refugees. Key variables, such as patients’ demographic characteristics, comorbidities, ED processes, hospital admission, and referral statuses, were collected and analyzed. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0. Results: The mean age of refugee patients was 39.1 ± 26.5 years, and they were younger than the local population. No significant difference was observed between the two groups in terms of examination waiting times and time to the first consultation (p = 0.721 and p = 0.060, respectively). Refugees were more frequently admitted to the ICU at the study hospital than the local population (85.4% vs. 61.0%, p < 0.001). Refugee status remained independently associated with ICU admission at the study hospital after adjustment for age, sex, and major comorbidities (adjusted OR: 2.57, 95% CI: 1.47–4.50; p = 0.001). Conclusions: In this study, no significant differences were observed between refugees and the local population in examination waiting time, time to first consultation, or ED length of stay. Refugees were younger and had a higher rate of ICU admission at the study hospital. These findings may contribute to a better understanding of healthcare utilization patterns among refugees requiring intensive care in Türkiye.

Leukoglycemic Index and Its Prognostic Implications in Diabetic and Nondiabetic Patients with Acute Pulmonary Embolism - Article abstract #947156

SARS-CoV-2 is a highly transmissible coronavirus and has caused a pandemic of acute respiratory disease. Genomic characterization of SARS-CoV-2 is important for monitoring and assessing its evolution. A total of 1.346 nasopharyngeal swab samples were collected but only 879 SARS-CoV-2 high-quality genomes were isolated, subjected to Next Generation Sequencing and analyzed both statistically and regarding mutations comprehensively. The distribution of clades and lineages in different cities of T & uuml;rkiye and the association of SARS-CoV-2 variants with age groups and clinical characteristics of COVID-19 were also examined. Furthermore, the frequency of the clades and lineages was observed in 10 months. Finally, non-synonymous mutations not defined in specific SARS-CoV-2 variants (during that period) were identified by performing mutation analysis. B.1.1.7 (Alpha) and B.1.617.2 (Delta) SARS-CoV-2 variants which have also been identified in our study from March to December 2021. We observed a significant association of SARS-CoV-2 variants with age groups and cities. Also, E:T9I, S:A27S, S:A67V, S:D796Y, S:K417N, S:N440K, S:R158X, S:S477N (below 1%-frequency) were determined as specific mutations belonging and shared with the Omicron variant that appeared later. Our study has highlighted the importance of constant monitoring of the genetic diversity of SARS-CoV-2 to provide better prevention strategies and it contributes to the understanding of SARS-CoV-2 from the past to the present.

Background: Emergency departments in Turkey employ both emergency medicine specialists (EMSs) and general practitioners due to an insufficient number of EMSs. Patients are triaged into green, yellow, and red codes based on urgency. Typically, EMSs manage more critical patients (yellow and red codes), while general practitioners handle less urgent cases (green codes).Objective: This study investigates differences in patient management approaches between EMSs and general practitioners in the yellow zone of an emergency department in the Sakarya Province.Method: This retrospective, cross‐sectional study was conducted at the Sakarya Training and Research Hospital from 31 December 2020 to 31 December 2021. The study included patients aged 18 and older who were assigned to the yellow zone and discharged by the attending physician. Data on patient monitoring times, consultation requests, hospitalization rates, resource utilization, readmission rates, and hospital revenue contributions were collected and analyzed. Statistical analyses were performed using IBM SPSS version 21, comparing the performance of EMSs and general practitioners.Result: The study included 59 physicians (14 EMSs and 45 general practitioners) and a large number of patients. EMSs had significantly more experience, shorter consultation request times, and higher ICU admission rates. They also ordered fewer MRIs and USGs per patient and made more consultation requests. There was no significant difference between EMSs and general practitioners in terms of the number of examinations, patient observation times, ward hospitalization rates, CT orders, readmission rates, and hospital revenue contributions.Conclusion: EMSs demonstrated more efficient use of emergency department resources, effective consultation processes, and higher ICU admission rates, indicating better patient management. Despite the limited scope of this single‐center study, the findings highlight the importance of EMSs in improving emergency care quality. Further research is needed to validate these results across multiple centers.

OBJECTIVES: There is no sufficient data to provide a clear picture of out-of-hospital cardiac arrest (OHCA) across Türkiye. This study is the first to present the prognostic outcomes of OHCA cases and the factors associated with these outcomes. MATERIALS AND METHODS: The study was conducted in a prospective, observational, multicenter design under the leadership of the Emergency Medicine Association of Turkey Resuscitation Study Group. OHCA cases aged 18 years and over who were admitted to 28 centers from Türkiye were included in the study. Survived event, return of spontaneous circulation (ROSC), survival to hospital discharge, and neurological outcome at discharge were investigated as primary outcomes. RESULTS: One thousand and three patients were included in the final analysis. 61.1% of the patients were male, and the average age was 67.0 ± 15.2. Cardiopulmonary resuscitation (CPR) was performed on 86.5% of the patients in the prehospital period by emergency medical service, and bystander CPR was performed on only 2.9% by nonhealth-care providers. As a result, the survived event rate was found to be 6.9%. The survival rate upon hospital discharge was 4.4%, with 2.7% of patients achieving a good neurological outcome upon discharge. In addition, the overall ROSC and sustained ROSC rates were 45.2% and 33.4%, respectively. In the multiple logistic regression analysis, male gender, initial shockable rhythm, a shorter prehospital duration of CPR, and the lack of CPR requirement in the emergency department were determined to be independent predictors for the survival to hospital discharge. CONCLUSION: Compared to global data, survival to hospital discharge and good neurological outcome rates appear to be lower in our study. We conclude that this result is related to low bystander CPR rates. Although not the focus of this study, inadequate postresuscitative care and intensive care support should also be discussed in this regard. It is obvious that this issue should be carefully addressed through political moves in the health and social fields.

Objective: In our study, the effect of earthquake victims who applied to the emergency department (ED) of our hospital, despite being far from the earthquake area, on the workload and the need for additional precautions will be examined. As a result, it is aimed to create a guiding resource for future disasters. Materials and Methods: This study was conducted with patients who applied to Sakarya Training and Research Hospital (STRH) Emergency Department within 15 days after the Kahramanmaraş earthquake and were diagnosed as X34-Earthquake Victims according to ICD-10. Results: The mean age of the 405 patients were 20.98 years, and 52.6% were female. The ratio of the admitted patients to the total number of patients was 1.62%. Regarding resource use, the laboratory was requested for 32.3%, imaging examination for 55.1%, consultation for 19%, and 353 patients were discharged from the emergency department. Conclusions: Although earthquake victims may apply to the emergency departments regardless of the distance after the earthquake, this number is insufficient to require additional measures regarding the workload it creates. However, since this study is the first analysis based on distance, it should be supported by similar studies.

Amaç: Bu çalışmada, hekim dışı sağlık çalışanlarına yönelik olarak yapılan Kardiyopulmoner Resüsitasyon (KPR) eğitimindeki başarı durumuna etki eden faktörlerin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma Sakarya İl Sağlık Müdürlüğü Acil Sağlık Hizmetleri Şubesi koordinatörlüğü ve sorumluluğunda Eylül 2021 tarihinde düzenlenen, KPR eğitimine katılan 285 hemşire ve ebe tarafından eğitim sırasında doldurulan ön test ve son test formlarının değerlendirilmesi ile gerçekleştirildi. Elde edilen veriler IBM SPSS 21 programı ile analiz edildi. Bulgular: Katılımcıların yaş ortalaması 25,06±3,45 yıl ve %85’i kadındı. Eğitime katılanların (n=285) son test başarı puanlarının 74,84±20,11 olduğu tespit edildi. Bu sonucun ön test başarı puanından (38,35±17,15) istatistiksel olarak anlamlı derecede yüksek olduğu saptandı (p

Tuberous sclerosis complex (TSC) is a rare genetic disease and affected individuals are usually characterized by the triad of cutaneous angiofibroma, mental retardation and epileptic seizures. Different clinical tables may occur due to the inflammatory response after COVID19. Apart from this, there is no article in the literature reporting that the frequency of seizures has increased as stated in the case example presented. A 30-year-old male patient was brought to our emergency room by his relatives with the complaint of epileptic seizures. Relatives of the patients stated that the frequency of seizures increased progressively after having COVID19 a month ago and that he had seizures 10 times in the last 24 hours. As seen in the case we presented, there may be an increase in the frequency of seizures in the late period after COVID19 in patients with epilepsy. For this reason, patients with an increased seizure frequency by emergency medicine physicians should also be evaluated for COVID19.

Introduction: This study was aimed to define the demographic structure of vaccinated patients admitted to the emergency room (ER) with COVID-19 symptoms, and their hospitalization status, length of stay (LoS) in hospital, and mortality status. Material and Method: This research is a retrospective, cross-sectional and descriptive study. Furthermore, it includes the period between 15.01.2021 and 30.04.2021. Results: An 887 COVID-19 vaccinated patients who applied to ER. Of these, 383 (42.2%) were male, and 504 (56.8%) were female. The mean age of the patients was 52±18.6 years. The number of single-dose vaccinated patients was 696 (78.5%), and the two-dose vaccinated was 191 (21.5%). CoronaVac (Sinovac Life Sciences) vaccine was applied to 755 (85.1%), and BNT162b2 (Pfizer & Biontech) vaccine was applied to 132 (14.9%) patients before. In 317 (35.7%) cases, reverse transcription-polymerase chain reaction (Rt-PCR) positivity was detected in the ER application after vaccination. Of the total patients, 86 (9.7%) were hospitalized, 14 (1.4%) patients died in the hospital. The mean time between vaccination and application to ER was 25 (±21.9) days. Also, this period was 28.1 (±18) days in two-dose vaccinated patients. Conclusion: People who are vaccinated with the COVID-19 vaccine continue to have hospital admissions with COVID-19 symptoms. Rt-PCR positivity, need for hospitalization, and mortality may continue to be seen in vaccinated individuals.

Background: Since its emergence, coronavirus disease 2019 (COVID-19) has been a challenge to manage and has resulted in high mortality rates. Aim: This study aimed to reveal the differences in the parameters at the time during the first admission, according to age groups in patients who applied due to Covid-19 and died in the hospital. Methods: This was a retrospective, cross-sectional, and descriptive study covering the period from March 16 to May 9, 2021. The study population (1169 patients) included patients with COVID-19 who presented to the emergency department and died in the hospital. The data required for this study were obtained from the electronic medical records of the patients in the information system of our hospital. The patients were divided into three groups and analyzed. Results: It was determined that the highest mortality rate was 547 (46.8%) in the 65-80 age group. In terms of comorbidities, there was a statistically significant difference between the three groups only in the incidence of asthma (p = 0.037). When the laboratory parameters and patient age groups were compared; a statistically significant difference was found in D-dimer, ferritin, WBC, platelet, and neutrophil values (respectively: p = 0.001, p = 0.020, p = 0.005, p = 0.029, p = 0.037). Conclusion: The highest death rate in Covid 19 patients is seen in the 65-80 age group. In patients over 80 years of age, the presence of asthma and the increase in D-dimer and ferritin levels among laboratory parameters can be used to predict mortality.