Analysis of geriatric patients with minor spinal trauma admitted to the emergency department of a university hospital

Objective:To retrospectively analyze patients aged 65 years and over,who were admitted to a level Ⅱ trauma center in Turkey due to minor spinal trauma in a period of 4 years.Methods:The study included 64 patients aged 65 years and over,who were admitted to the Emergency Department of Baskent University Ankara Hospital between January 2011 and January 2015 and diagnosed with vertebral trauma.The information of the patients was obtained from the medical records.The clinical characteristics of patients including localizafions and types of fracture,presence of additional system injuries and treatment options were investigated.Results:The most common cause was fall,accounting for 51 (79.7%),with 7 (10.9%) due to intra-vehicle traffic accident,and 6 (9.4%) due to out-of-vehicle pedestrian injury.The most common site of trauma was the lumbar region.Of the fractures,46.9% (n=30) were in the lumbar region,37.5% (n=24) in the thoracic region and 15.6% (n=10) were in the cervical vertebra region.Fourteen (21.9%) patients had an additional injury.Given the fracture types,47 fractures (74.6%) were compression,14 fractures (22.2%) were spinous process and 2 fractures (3.2%) were burst fractures.Twenty patients (31.2%) had multilevel vertebral fractures.Conclusions:The results of our study demonstrated the importance of vertebral fractures in the geriatric age group.In this age group,falls and motor vehicle accidents are the leading causes of vertebral traumas.Taking the necessary measures to prevent the risk factors which increase with aging is the most important step in preventing the mortality and morbidity that may occur as a result of vertebral fracture.

The red cell distribution width to platelet ratio predicts 30-day mortality of acute pulmonary embolism patients

Objective: To specify the clinical and sociodemographic characteristics, risk factors, factors affecting mortality including hematologic parameters, and red blood cell distribution width to platelet ratio (RPR) in patients with pulmonary thromboembolism, and to reduce the mortality. Methods: The archive records of patients diagnosed with pulmonary embolism were retrospectively examined. The histories, risk factors, physical examination findings, arterial blood gas analysis, X-rays, laboratory, and computed tomography reports of all cases were obtained via the hospital information system. Logistic regression analysis was performed to determine the independent variables affecting early mortality. Results: A total of 146 patients with a definitive diagnosis of pulmonary thromboembolism were included. Thirteen point seven percent (n=20) of the deceased patients died at early term. Ninety percent of patients with early mortality was 65 years or older. There were significantly differences in age, RPR, D-dimer, creatinine, lymphocyte, pH, and body temperature between patients with and without early mortality (P=0.017, P<0.001, P=0.019, P=0.025, P=0.042, P=0.013, P=0.017, respectively). Logistic regression analysis showed that RPR was a statistically significant and independent risk factors of mortality (P=0.026, OR: 0.254., 95% CI (0.326-5.056))In addition, there was a significant difference in pulmonary embolism severity index classification between patients with and without early mortality(P<0.034). Conclusions: RPR is an independent risk factor of mortality of pulmonary embolism patients and may help emergency physician to stratify mortality risks of pulmonary embolism patients.

Epidemiological and clinical data of patients with stings and bites at a medical center of Turkey

Objective: To analyze the epidemiological and clinical data of patients who were admitted to ?n?nü University Turgut ?zal Medical Center Emergency Department with bites and stings between 2013 and 2015. Methods: Patients with bites and stingings who were admitted to ?n?nü University Turgut ?zal Medical Center during 2013-2015 were selected for this retrospective evaluation. We retrived the following information including age, gender, anatomic localization of the sting or bite, admission time, complaints, vital signs, length of stay, laboratory findings and hospitalization department. Pearson's chi-square test, Fisher's exact test, One-way ANOVA test and the Bonferroni correction as post hoc were used for statistical analysis. Results: The mean age of the patients was (43.51±16.90) years, and 55% were male. The most common admission reason was pain (34.7%), followed by rash (19.1%) and panic (11.6%). A total of 16.8% of the admissions occurred in July, 16.8% in August and 16.5% in June while the occurrence was the lowest in November with 1.5%. The most prevalent bites or stinging animals were scorpions (34.6%), followed by ticks (19.7%) and bees (12.9%). Antihistaminic-steroid-tetanus and analgesic-antihistaminic-steroid combinations were administered, respectively to 59.6% and 25% of the patients. The longest length of stay was (48.56±26.92) h due to snake bites. Conclusions: The community should be educated about the living areas of these animals, the seasons and hours in which they are active. Since individuals living and working in rural areas are at risk, more education should be given to them.