Investigation of the prognostic role of systemic immunoinflammatory index in patients with acute pancreatitis.

BACKGROUND: The aim of this study was to examine the effect of systemic immunoinflammatory index (SII), calculated on presentation to the emergency department (ED), on the prediction of clinical outcomes of patients who were diagnosed with acute pancreatitis (AP). METHODS: This research was designed as a single-center, cross-sectional, and retrospective study. Adult patients who were diag-nosed with AP in the ED between October 2021 and October 2022 in the tertiary care hospital, whose diagnostic and therapeutic procedures were complete in the data recording system, have been included in the study. RESULTS: Mean age, respiratory rate, and length of stay of the non-survivors were significantly higher than the mean of the survivors (t-test, p=0.042, p=0.001, and p=0.001, respectively). Mean SII score of the patients with fatal outcome was higher than the survivors (t-test, p=0.001). ROC analysis of the SII score to predict mortality revealed that the area under the curve was found to be 0.842 (95%CI 0.772-0.898), and the Youden index was 0.614, (p=0.001). When the cutoff value of the SII score in determining mortality is 1243, the sensitivity of the score was found to be 85.0%, specificity 76.4%, positive predictive value 37.0%, and negative predictive value 96.9%. CONCLUSION: SII score was statistically significant in estimating mortality. SII calculated on presentation to the ED can be a useful scoring system to predict the clinical outcomes of patients who were admitted to the ED and were diagnosed with AP.

Use of the AIMS65 and pre-endoscopy Rockall scores in the prediction of mortality in patients with the upper gastrointestinal bleeding.

BACKGROUND: Upper gastrointestinal (GI) bleeding is one of the most common reasons for emergency department (ED) visits. This study aimed to evaluate the predictive power of the AIMS65 and pre-endoscopy Rockall scores in predicting in-hospital mortality in patients that presented to ED and were diagnosed with the upper GI bleeding. METHODS: Data of patients aged 18 years and older, who visited ED of Kartal Dr. Lütfi Kirdar City Hospital during the study period and were diagnosed with upper GI bleeding, were obtained from the electronic-based hospital information system and analyzed retrospectively. Each scoring system was compared using the receiver operating characteristic (ROC) curve analysis. RESULTS: The study was completed with 592 patients. The mean age of the patients was 63.5±19.0 years, and 68.6% were male. The total in-hospital mortality rate was 5.2%. In the ROC analysis of the AIMS65 and pre-endoscopy Rockall scores in the prediction of in-hospital mortality, the area under the curve values was calculated as 0.822 (95% confidence interval [CI]: 0.788-0.852) and 0.777 (95% CI: 0.741-0.810), respectively. When these two scoring systems were compared, neither had statistically significant superiority over the other in predicting in-hospital mortality. CONCLUSION: The AIMS65 and pre-endoscopy Rockall scores can be used to predict in-hospital mortality in patients with GI bleeding. However, since the AIMS65 score consists of only five variables that can easily be calculated in ED, we recommend its use in clinical practice.

COVID-19 patients in the operating room: a concise review of existing literature.

A novel Coronavirus was identified in late 2019 as the cause of COVID-19 disease which is highly contagious. SARS-CoV-2 is a single-stranded RNA, enveloped virus from the beta Coronavirus family. Intraoperative management of patients with COVID-19 is a high-risk procedure. An international attention has raised to develop recommendations for the management strategies. This review article was designed to synthesize the existing evidence and experience related to intraoperative management of COVID-19. This review provides a summary of clinical guidance and addresses six domains: principles of intraoperative monitoring, airway management and related difficulties, ventilation, type of anesthesia, medications and side effects, and intraoperative fluid management.