The impact of body mass index values on the quality of cardiopulmonary resuscitation: A manikin study

WOS:000681330400012Küçükceran, K. , Ayrancı, M. Özer, M. R. (2021). The impact of body mass index values on the quality of cardiopulmonary resuscitation: A manikin study. Clinical and Experimental Health Sciences , 11 (2) , 269-272

Covid-19 hastalarında yoğun bakım yatışı ile ilişkili faktörler

Aim: In this study, it was aimed whether biochemical parameters, vital signs and neutrophil-lymphocyte ratio (NLR) values could be used in determining the indication for intensive care hospitalization in COVID-19 patients. Patients and Methods: This retrospective observational study was conducted in the emergency department of a university hospital. Patients with positive SARS-CoV-2 PCR test who applied to our hospital on 1-31 July 2020 were included in the study. Laboratory results, demographic findings and clinical results of the patients were collected electronically. The patients were divided into 3 groups as discharged, admitted to the service or intensive care unit. The incidence and severity of symptoms, comorbidities, laboratory values, and NLR values were compared between the groups. Results: A total of 489 patients were included in the study. The mean age of the included patients was 48.69 + 17.25 years, of which 260 (53.16%) were female. While 248 (50.9%) of these patients were discharged, 207 (42.3%) were taken to the service and 33 (6.7%) to the intensive care units. Age, heart rate, urea, creatinine, CRP, D-dimer and NLR values of the patients admitted to the intensive care unit were higher than the other groups, while oxygen saturation was statistically significantly lower in this group. Concomitant systemic diseases such as Diabetes Mellitus, Essential Hypertension, Chronic Obstructive Pulmonary Disease were more common in those hospitalized in the intensive care unit. In multivariable analysis, oxygen saturation (OR:0.803) and neutrophil-lymphocyte ratio (OR:1.09) were found to be independent predictors of the indication for hospitalization in the intensive care unit. Conclusion: As a result of our study, we think that especially low oxygen saturation and high neutrophillymphocyte ratio can be used in determining the indication for intensive care hospitalization in patients who apply to the emergency department due to COVID-19.Amaç: Bu çalışmada biyokimyasal parametreler, vital bulgular ve nötrofil-lenfosit oranı (NLR) değerlerinin COVID-19 hastalarında yoğun bakım yatış endikasyonunun belirlenmesinde kullanılabilir olup olmadığı amaçlandı. Hastalar ve Yöntem: Bu retrospektif gözlemsel çalışma, bir üniversite hastanesinin acil servisinde gerçekleştirildi. 1-31 Temmuz 2020 tarihinde hastanemize başvurmuş SARS-CoV-2 PCR testi pozitif olan hastalar çalışmaya dahil edildi. Elektronik ortamda hastaların laboratuvar sonuçları, demografik bulguları ve klinik sonuçları toplandı. Hastalar taburcu edilmiş, servise veya yoğun bakıma yatışı yapılmış olarak 3 gruba ayrıldı. Gruplar arasında semptomların görülme sıklığı, şiddeti, ek hastalıklar, laboratuvar değerleri, NLR değerleri kıyaslandı. Bulgular: Çalışmaya toplam 489 hasta dahil edildi. Dahil edilen hastaların ortalama yaşı 48.69 + 17.25 yıl iken bunların 260’ı (%53,16) kadındı. Bu hastaların 248’i (%50,9) taburcu edilirken, 207’si (%42,3) servislere, 33 (%6,7)’ü de yoğun bakım ünitelerine alındı. Yoğun bakıma yatış yapılan hastaların yaş, kalp hızı, üre, kreatinin, CRP, D-dimer ve NLR değerleri diğer gruplara kıyasla yüksekken, bu grupta oksijen saturasyonu ise istatiksel olarak anlamlı derecede düşüktü. Yoğun bakımı yatışı olanlarda Diabetes Mellitus, Esansiyel Hipertansiyon, Kronik Obstrüktif Akciğer hastalığı gibi eşlik eden sistemik rahatsızlıklar daha fazlaydı. Çok değişkenli analizde oksijen satürasyonu (OR:0.803) ve nötrofil-lenfosit oranı (OR:1.09) yoğun bakım ünitesinde yatış endikasyonunun bağımsız öngördürücüsü olarak b ulundu. Sonuç: Çalışmamızın sonucunda acil servise COVID-19 nedeni ile başvuran hastalarda özellikle düşük oksijen satürasyonu ve yüksek nötrofil-lenfosit oranının yoğun bakım yatış endikasyonun belirlenmesinde kullanılabileceklerini düşünüyoruz

Roles of CRP and neutrophil-to-lymphocyte ratio in the prediction of readmission of COVID-19 patients discharged from the ED

WOS:000972110800001PubMed ID:36761852Background: Patient admissions beyond the capacity of emergency departments (EDs) have been reported since the coronavirus disease (COVID-19) pandemic. Thus, laboratory parameters to predict the readmission of patients discharged from the ED are needed. For this purpose, we investigated whether C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR) could predict the readmission of patients with COVID-19. Methods: Patients aged >18 years who visited the ED in October 2020 and had positive polymerase chain reaction test results were evaluated. Among these patients, those who were not hospitalized and were discharged from the ED on the same day were included in the study. The patients' readmission status within 14 days after discharge, age, sex, complaint on admission, comorbidity, systolic blood pressure, diastolic blood pressure, fever, pulse, oxygen saturation level, CRP level, blood urea nitrogen level, creatinine level, neutrophil count, lymphocyte count, and NLR were recorded. Data were compared between the groups. Results: Of the 779 patients who were included in the study, 359 (46.1%) were male. The median age was 41 years (range, 31-53 years). Among these patients, those who were not hospitalized and were discharged from the ED on logistic regression analysis, age, CRP level, NLR, loss of smell and taste, and hypertension had odds ratios of 2.494, 2.207, 1.803, 0.341, and 1.879, respectively. Conclusions: The strongest independent predictor of readmission within 14 days after same-day ED discharge was age > 50 years. In addition, CRP level and NLR were the laboratory parameters identified as independent predictors of ED readmission

Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome

Aim: The aim was to evaluate the levels of serum pentraxin-3 (PTX-3) and neutrophil gelatinase-associated lipocalin (NGAL) and the efficiency of making a diagnosis and to estimate the prognosis in patients with chest pain.Materials and Methods: The study was conducted in the Necmettin Erbakan University Meram Medicine School Emergency Department. Patients who had chest pain and met the inclusion criteria were accepted. They were divided into the following groups: acute coronary syndrome (ACS), a diagnosis other than ACS (non-ACS), and control. The patients in theACS and non-ACS groups were divided into five sub-group -groups: ST Elevated Myocardial Infarction (STEMI) Non- ST Elevated Myocardial Infarction (NSTEMI), Unstable Angina Pectoris (USAP), stable angina, and pulmonary embolus. For all patients, serum PTX-3, serum NGAL, troponin I, and creatine kinase-MB fraction (CK-MB) levels were measured.Results: There were 199 patients in the ACS and non-ACS groups and 30 patientsin the control group. There was no significant difference among the study groups in terms of age and PTX-3 and NGAL levels. When comparing survival and non-survival in terms of in-hospital death, CK-MB and troponin I levels were significantly higher in the ACS and non-ACS groups than in the control groups, whereas there was no significant difference in terms of PTX-3 and NGAL levels.Conclusion: The results of our study demonstrated that PTX-3 and NGAL are not effective biomarkers in the differential diagnosis and the determination of in-hospital mortality in ACS. However, the limitations of the study should be considered. The results confirmed that CK-MB and Troponin I can be safely used in the differential diagnosis and the prediction of mortality

Acil serviste pulmoner tromboembolili hastaların farklı puanlama araçları ile değerlendirilmesi

Amaç: Acil serviste pulmoner tromboemboli (PTE) tanısı alan hastaların mortalite ile demografik, klinik, laboratuvar ve skorlamaözellikleri arasındaki ilişkiyi araştırmak.Gereç ve Yöntem: Bu retrospektif çalışmada, 2012-2015 yılları arasında acil servise başvuran torasik bilgisayarlı tomografi (BT) veyapulmoner BT anjiyografisi ile PTE tanısı alan 166 hasta çalışmaya dahil edildi. Hasta grubu Grup I (sağ kalan) ve Grup -II (hayattakalmayan)olarak iki gruba ayrıldı. Hematolojik ve biyokimyasal laboratuvar parametreleri, laktat içeren arteriyel kan gazı değerleri vetüm hastaların klinik şiddeti MWS, PESI ve MEWS skorlama sistemleri kullanılarak değerlendirildi.Bulgular: Arteriyel oksijen basıncı (PaO2) ve laktat düzeyleri açısından, hasta grupları arasında istatistiksel olarak anlamlı bir farkbulundu. Grup II'de, PESI ve MEWS skorları Grup-I hastaları ile karşılaştırıldığında anlamlı olarak yüksek bulundu. Grup II hastalarındaMWS skoru daha yüksekti.Sonuç: Burada kullanılan parametreler ve skorlama araçları sayesinde, PTE olgularını tanılamayı amaçladık. PTE'nin bu bulgularınyardımıyla klinisyen tarafından daha erken teşhis edildiğinde, mortalite ve morbidite oranlarının azaltılacağını ve tedavinin dahaetkili olacağını düşünmekteyiz.Objective: To investigate the association between the mortality, and the demographic, clinical, laboratory and scoring features of thepatients diagnosed with pulmonary thromboembolism (PTE) in the emergency department.Material and Methods: This retrospective study included 166 patients diagnosed with PTE through thoracic computerized tomography(CT) or pulmonary CT angiography referred to emergency services between 2012 and 2015. The patients group was classifiedinto two groups as Group-I (survival) and Group-II (non-survival). Hematological and biochemical laboratory parameters, arterialblood gas values including lactate and the clinical severity of all patients were assessed using MWS, PESI and MEWS scoring systems.Results: In terms of arterial oxygen tension (PaO2) and lactate levels, a statistically significant difference was observed between thepatient groups (p0,043, p0.001) While PESI and MEWS scores were found to be significantly higher among in Group-II patients,compared to those in Group-I (for both, p0.001).Conclusion: Thanks to the parameters and scoring tools used, it is aimed at diagnosing and treating PTE cases earlier. . Based on thesefindings, we consider that the clinician’searly diagnosis of PTE by following the present manifestations and evaluating the course ofthe treatment will decrease the rates of mortality and morbidit