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Browsing by Department "Acil Tıp Ana Bilim Dalı"

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    Conditions that mimic stroke in elderly patients admitted to the emergency department
    (Elsevier, 2013-05-26) İnal, Taylan; Köse, Ataman; Armaǧan, Erol; Kıyak, Ramazan; Demir, Aylin Bircan; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0001-6739-8605; AAM-7896-2020; V-7170-2017; L-7334-2015; AAH-8846-2021; 15755792500; 6506464232; 55948964800; 57217395786
    Background: Stroke is the most common neurologic cause for patient admission to the emergency department (ED) and the risk of stroke increases with age. This study aimed to determine the clinical and demographical characteristics of stroke-mimicking patients 65 years or older who were admitted to the ED for stroke. Methods: After the retrospective file examination, patients 65 years and older who were admitted to the ED with an established final diagnosis of stroke as a result of history, physical examination, imaging, and required consultations were included in the study. Results: After scanning 671 records of patients 65 years or older, 87.3% (n = 586) were diagnosed with stroke and 12.7% (n = 85) received different diagnoses mimicking stroke. Of these 85 patients, 91.8% (n = 78) and 8.2% (n = 7) were prediagnosed with ischemic stroke and transient ischemic attack, respectively, by the ED physicians. After complete evaluations and consultations, the patients with stroke were typically diagnosed with vertebrobasilar insufficiency (n = 16, 18.8%). Of the patients, 76.5% (n = 65) were discharged after treatment and follow-up in the ED, and 21.1% (n = 18) were hospitalized. Conclusions: In older patients, stroke-mimicking conditions can cause signs and symptoms indistinguishable from true stroke, representing about 12.7% of elderly patients admitted to an ED with these diagnoses.
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    Predictive value of the modified early warning score in a Turkish emergency department
    (Lippıncott Williams & Wilkins, 2008-12) Armağan, Erol; Yılmaz, Yusuf Cem; Ölmez, Ömer Fatih; Şimşek, Gözde; Gül, Cuma Bülent; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-2467-9356; 0000-0003-4518-5283; A-7063-2018; AAH-8846-2021; K-6651-2012; 6506464232; 22936014300; 26435400000; 57225727701; 23988796000
    Objective The modified Early Warning Score (mEWS) is a triage instrument that promises to predict patient disposition and clinical outcome in emergency departments (EDs). We investigated whether mEWS can predict death, hospital admission, intensive care unit (ICU) admission, and in-hospital deaths in a Turkish setting. Methods We conducted an ED-based prospective study of 309 patients who presented to an academic medical center. The mEWS was recorded in all patients on ED admission. A mEWS >4 was used to define patients at high-risk for the study outcomes. Results Patients categorized as being at high-risk either were admitted to ICU (n = 23) or to hospital (n = 37) 56.6% of the time, or died in ED (n = 16) or in hospital (n = 29) 42.4% of the time. Patients categorized as being at low-risk either were admitted to ICU (n = 25) or to hospital (n = 52) 37.4% of the time, or died in ED (n = 1) or in hospital (n = 4) 2.5% of the time. In multivariate regression analysis, patients with a mEWS of 5 or more were 1.95 times more likely to be admitted to ICU than those with a score less than 5. Patients with high-risk mEWS were 35 times more likely to die in ED and 14 times more likely to die in hospital than those presenting with a low-risk score. Conclusion We conclude that scores on the mEWS predict ICU admission as well as ICU and in-hospital deaths.