Ulus Travma Acil Cer
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Objective evaluation of the severity of injured patients is crucial for the adequate triage, decision-making, operative and intensive care management, prevention, outcome studies and system quality assessment. This study aimed to compare six, widely- used, trauma scores as predictors of mortality, and to identify the most powerful among them in limited-resources settings. ⋯ According to our study the most powerful mortality predictors are APACHE 2 and TRISS, even in limited-resources hospital settings, while statistically significant KTS, did not perform as expected. We propose the appliance of the KTS, as the tool for exploiting 'golden hour', ISS or NISS during admission stage and APACHE 2 or TRISS for use in the first 24 hours after admission to ICU.
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Ulus Travma Acil Cer · Oct 2022
The effect of emergency room consultations on emergency general surgery operations.
Hospitalizations in emergency general surgery (EGS) cases in the USA have increased by 28% since 2001. The costs of these cases are estimated to increase by 45% annually until 2060, reaching 41.20 billion dollars. According to the literature, the general surgery clinic team allocates an average of 5.5 hours a day for emergency room consultations. The aim of this study is to determine the effects of consultations from the emergency room in our country on the EGS approach and to create appropriate solution proposals with the data obtained from the regional hospitals. ⋯ The hospitalization/consultation rate was evaluated as the success of the doctors working at the emergency department in recognizing EGS cases; the average value was 20.15% across all hospitals. The surgery/emergency hospitalization rate, which shows rate of the hospitalized patients underwent surgery, is 59.17% when all centers are taken into account. The rate of surgery/admission in acute cholecystitis cases is 31.49% for all centers. It is seen that the hospitalization/consultation rate decreases with the increase in hospital workload. The rate of laparoscopic/total appendectomy is 22.78% across all centers. There is a correlation between acute appendicitis cases and EGS consultation numbers, but there is no correlation between laparoscopic appendectomy and consultation numbers. In addition, it is seen that medical follow-up is preferred in acute cholecystitis cases in centers where the consultation burden is increased; cholecystectomy is preferred at a higher rate in centers where the consultation burden is less. National EGS systems are needed and tried to be developed in order to improve the approach and outcomes of EGS patients worldwide. It is considered essential to establish a national EGS maintenance system that coordinates country resources and optimizes outcomes.
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Ulus Travma Acil Cer · Oct 2022
The initial analysis of pediatric fractures according to the AO/OTA fracture classification and mechanisms of injuries.
The epidemiology of pediatric fractures has been changing timely, in a multifactorial fashion. The aim of this study was to put forward a recent 5-year epidemiological analysis of pediatric fractures, according to the current AO/OTA fracture classification, in the current decade of action for road safety. ⋯ To the best of our knowledge, this study represents the first analysis of pediatric fractures according to the AO/OTA classification, over a 5-year period. As a future prospect, further multicentric epidemiological studies are warranted to constitute a sustainable action plan for the prevention of major traumas.
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Ulus Travma Acil Cer · Oct 2022
Case ReportsMultiple giant jejunal diverticulosis: A rare clinical presentation of a rarely encountered disease.
Jejunoileal diverticula have a four-fold greater risk of developing general complications and an 18-fold greater risk of perforation compared to duodenal diverticula. While resection is not preferred in asymptomatic cases, surgical intervention may be required in life-threatening conditions. In this case report, a 69-year-old male patient with multiple giant jejunal diverticulum presenting with long-standing and transient symptoms was presented. ⋯ During the patient's last admission to the emergency department, contrast-enhanced abdominal computed tomography was ordered and revealed jejunum segments with multiple giant diverticula which were treated by excision by open laparotomy. It was observed that the patient's complaints did not recur and he started to gain weight. In patients admitted to the emergency department with complaints of long-standing abdominal pain, weight loss, and bloating, in whom diagnosis cannot be made, it is recommended to consider diverticulum originating from the jejunum in the differential diagnosis, especially in the presence of abdominal surgery history.
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Ulus Travma Acil Cer · Oct 2022
Evaluation of gastroesophageal reflux in pediatric laparoscopic appendectomy procedures.
The increased intra-abdominal pressure during laparoscopic surgical procedures was reported to be a factor in the development of gastroesophageal reflux. This study evaluated the presence of gastroesophageal reflux and associated factors using 24-h pH monitoring in children undergoing laparoscopic appendectomy. ⋯ The lack of a significant relationship between mean procedure time and gastroesophageal reflux suggests that the mean duration of the laparoscopic procedures performed in this study is safe in terms of gastroesophageal reflux. The results also indicate that young age and low weight should be considered risk factors for gastroesophageal reflux in pediatric patients undergoing laparoscopic appendectomy.