Analysis of the Patients Who Admitted To A Turkish Emergency Department During COVID-19 Pandemic

BACKGROUND AND AIM: In this study, it was aimed to review patients who presented to a Turkish emergency department (ED) with fever and at least one symptom and finding of acute respiratory infection (cough, shortness of breath) in Sisli Hamidiye Etfal Education and Research Hospital Tertiary Medical Care Center during COVID-19 pandemic. METHODS: This retrospective, descriptive, observational study included patients presented between March 10, 2020 and April 25, 2020. The patients were classified into two groups according to RT-PCR test result: RT-PCR (+) and RT-PCR (-). The demographic characteristics and clinical endpoint-related factors were analyzed in the patients. RESULTS: The study included 840 patients; 461 men (54.9%) and 379 women (45.1%). RT-PCR test was positive in 345 patients (41.0%). The most common comorbidity was hypertension (HT) in 119 patients (34.5%); followed by diabetes mellitus (DM) in 61 patients (18.3%). At time of ED presentation, there was mild clinical manifestation in 72.2%, whereas moderate in 21.7% and severe in 6.1% of patients with positive RT-PCR testing. Of the patients with positive RT-PCR testing, 64 patients (18.6%) were discharged from ED while 255 patients (73.9%) were admitted to COVID clinic and 26 were admitted to COVID intensive care unit (ICU). Of the patients admitted, 299 patients (86.7%) were discharged while 46 patients (13.3%) died due to multi-organ failure (MOF) (50%), acute respiratory distress syndrome (ARDS) (32.6%), acute pulmonary embolism (APE) (10.9%) and acute coronary syndrome (ACS) (6.5%). CONCLUSIONS: The RT-PCR positivity rate seemed lower in our study when compared to literature. In addition, mortality rate was lower in our study when compared to other countries.

Correlation of CAT Score With Peak Expiratory Flow in Acute Exacerbation of COPD Patients.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) leads to physical activity limitation and a significant reduction in quality of life. This study aimed to investigate the correlation between The COPD Assessment Test (CAT) score and peak expiratory flow (PEF), and the factors effecting hospital admission rates of patients with COPD. METHODS: This observational study was conducted prospectively. CAT score was calculated and PEF measured at the time of emergency department admission. Descriptive statistics were expressed as number (n), percentage (%), and mean ± standard deviation. Chi-Square and correlation tests were used for statistical analyses. A p value of less than 0.05 was considered statistically significant. RESULTS: Of 123 patients included in the study, 85 (69.1%) were male and 38 (30.9%) were female. Pulse pressure, pH, blood urea nitrogen, oxygen saturation measured by pulse oximetry (SpO2), PO2, PCO2, and SpO2 values on arterial blood gas analysis, and PEF value were significantly correlated to CAT score (p < 0.05). CONCLUSION: High CAT score and low PEF value can be used to make the decision of hospitalization from emergency department in acute exacerbations of COPD.

Subcutaneous emphysema, pneumo-orbita and pneumomediastinum following a facial trauma caused by a high-pressure car washer.

Pneumomediastinum is air leakage to mediastinal space from various potential sites, including lung, esophagus, trachea, and neck. It is a rare condition that develops either spontaneously with increased intraalveolar or intrabronchial pressure, or due to trauma. Although cases where face or neck trauma with subcutaneous emphysema that extended to mediastinal cavity via anatomical connections in face and neck have been reported, orbital traumas leading to pneumomediastinum are very rare occurrences that have seldom been reported. This paper documents a 17-year-old male who presented with diffuse subcutaneous emphysema involving paraorbital facial areas, which extended to neck and mediastinal cavity.

Occupational injury patterns of Turkey.

INTRODUCTION AND AIM: Each year, a significant number of people die or become handicapped due to preventable occupational accidents or occupational diseases. The aim of this study was to investigate socio-demographic features, mechanism, causes, injury area, and sectoral features of occupational accidents in patients presented to our department. MATERIALS AND METHODS: The study was carried out retrospectively after local ethics committee approval. Age and sex of the patients, mechanism of injury, type and exact location of injuries were all evaluated. The groups were compared using Chi-Square test, Student's T test and Kruskall-Wallis test. p value <0.05 was accepted as statistically significant. RESULTS: Totally 654 patients were included in the study. 93.4% of patients were male, and mean age was 32.96 ± 5.97 (18-73) years. Sectoral distribution of accidents was statistically significant and mostly occurred in industrial and construction workers (p < 0.05, respectively). There is a statistically significant relationship between educational level and sector of the worker (p < 0.05). While the most frequent cause of admission to emergency department was penetrating injuries (36.4%), the least was due to multiple traumas (0.5%). Distribution of occupational accidents according to injury type was statistically significant (p < 0.05). The mean Injury Severity Score (ISS) was 9.79 ± 8.1. The mean cost of occupational injury was $1729.57 ± 8178.3. There was statistically significant difference between the sectors with respect to cost. Seventy-one patients (10.9%) recovered with permanent sequel and two (0.3%) died in hospital. CONCLUSION: Occupational accidents are most commonly seen in young males, especially in primary school graduated workers, and during daytime period.