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Aci̇l servi̇ste i̇nme tanısı almış 65 yaş üzeri̇ hastaların retrospekti̇f kli̇ni̇k ve görüntüleme özelli̇kleri̇nin deǧerlendi̇ri̇lmesi̇
(Güneş Kitabevi, 2013) İnal, Taylan; Armaǧan, Erol; Köse, Ataman; Köksal, Özlem; Özdemír, Fatma; Akköse, Şule; Balcı, Arif Kadri; Demir, Aylin Bircan; Tıp Fakültesi; Nöroloji Ana Bilim Dalı; 0000-0003-2271-5659; AAH-8846-2021; AAK-8332-2020; L-7334-2015; AAM-7896-2020; 55695563500; 6506464232; 15755792500; 23389880200; 7006765911; 6603347542; 57225396135; 57217395786
Introduction: Elderly population in the World has been increasing gradually. In terms of emergency service, the elderly constitute a special group. We aimed to study the demographic, clinical, and imaging findings in patients who are 65 years and older presented to Emergency Department. Materials and Method: By obtaining the data of the patients with stroke diagnosis, who are 65 and older and who applied to Emergency Department between 01.01.2011 and 29.02.2012, demographic, clinical, and imaging findings were investigated and then compared among 65-74, 75-84 ve >85 age groups in this study. Results: According to the study results, among the age groups of 65-74, 75-84 and >= 85, significant difference was not found out between gender, complaints for application, duration of complaints, and comorbidities. Similarly, among physical examination findings such as consciousness, eye movements, visual fields, facial nerve examinations, lower and upper extremity motor functions, ataxia, negligence, aphasia, dysarthria, and NIHSS scores, statistically significant difference was not established. Besides, no significant difference was found among diagnoses, Cranial Computed Tomography and magnetic resonance imaging findings. Following the statistical analyses, the parameters revealing significant differences among age groups were conscious status, sense examinations, infarct in Cranial Computed Tomography, and bleeding sides. Conclusion: As a result of our study, we have seen that etiology of stroke may alter along with advancing age, however; in terms of clinical characteristics and patient results in hospitalization, discharge and mortality statistically significant differences were not observed.
Analysis of appropriate tetanus prophylaxis in an emergency department
(Türk Travma ve Acil Cerrahi Dergisi, 2013-07) Şimşek, Gözde; Armaǧan, Erol; Köksal, Özlem; Heper, Yasemin; Pozam, Suna Eraybar; Durak, Vahide Aslıhan; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-4306-9262; 0000-0003-2271-5659; HIK-0672-2022; AAE-9483-2021; AAK-8332-2020; CAF-5149-2022; AAH-8846-2021; AAH-6506-2021; Y-3674-2018; 57225727701; 6506464232; 23389880200; 56191003300; 55791934000; 55792633100
BACKGROUND In this study, our aim was to identify the validity of the prophylaxis indications for patients who received tetanus prophylaxis, determine the ratio of high-risk wounds to the number of patients with immunity, and to evaluate the tetanus immunity of specific age groups. METHODS Patients who applied to the Emergency Department (ED) between September 2009 and May 2010 and who were considered for tetanus prophylaxis by his/her primary care physician were included in the study. RESULTS A total of 320 patients were evaluated. The average age of the patients was 40.87 +/- 15.83 years. A total of 73.1% of the patients were male and 26.8% were female. A total of 40.3% of the patients knew their vaccination history, while 59.7% had no recollection of their vaccination history. 14.7% of the patients had received their last dose within 5 years and 48.1% within 5-10 years; 37.2% of the patients declared that more 10 years had passed since their last vaccination. In 75% of the patients, the tetanus immunoglobulin (Ig)G level was identified as >= 0.1 IU/ml, while 25% of the patients had levels <0.1 IU/ml. The number of patients with protective levels was lower among those who were illiterate or who had only a primary school education, and this difference was statistically significant (p<0.001). CONCLUSION The vaccination histories can be misleading. Certain equipment can be used at the bedside to determine a patient's tetanus immunization status.
Analysis of the necessity of routine tests in trauma patients in the emergency department
(Türk Travma ve Acil Cerrahi Derneği, 2012-01) Köksal, Özlem; Çevik, Şebnem Eren; Aydın, Şule Akköse; Özdemir, Fatma; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-2271-5659; 0000-0001-7602-8104; AAK-8332-2020; 23389880200; 54894485300; 15757217900; 7006765911
BACKGROUND: The necessity of routine tests as regarded in the Advanced Trauma Life Support protocols has become controversial in recent years. The aim of this study was to analyze the necessity of routine tests in trauma patients. METHODS: This was a prospective study. A total of 103 blunt trauma patients aged between 15 and 65 years who presented to the emergency department with major trauma, Glasgow Coma Scale of 15 and Revised Trauma Score of 12 were admitted to the study. RESULTS: The average age of the patients (30.1% female, 69.9% male) was 35 +/- 12.97 years. A total of 72.8% of the patients presented for motor vehicle crashes, 12.6% for pedestrian injury and 14.6% for fall from a height. All of the routine tests were evaluated separately. With the exception of cervical examination-lateral cervical X-ray results and pelvic examination-complete blood count and urinalysis test results, significant relations were determined between the reason for requiring a test and the results of the other tests (complete blood count, lateral cervical X-ray and abdominal ultrasonography). CONCLUSION: According to our study, biochemical tests, anterior-posterior chest X-ray and anterior-posterior pelvic X-ray can be ordered as targeted tests. Conducting targeted tests will reduce costs and workload.
Comparison of trauma scoring systems for predicting mortality in firearm injuries
(Ulusal Travma ve Acil Cerrahi Derneği, 2009-11) Köksal, Özlem; Özdemir, Fatma Ayça Edis; Bulut, Mehtap; Aydın, Şule; Almacıoğlu, Meral Leman; Özgüç, Halil; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-2271-5659; AAX-5571-2021; AAK-8332-2020; 23389880200; 7006765911; 56233163200; 6603347542; 35784090800; 6603867989
Prediction of mortality in trauma patients is an important part of trauma care. Trauma Scoring systems are the current methods used for prediction of mortality. We aimed to evaluate and compare the performances of Injury Severity Score (ISS) and New Injury Severity Score (NISS) in firearm injuries. Records of 135 firearm-injured patients who applied to Uludag University Emergency Department between January 2001 and December 2005 were analyzed retrospectively. All patients' data, including age, gender, cause of injury, initial vital signs, injury region, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), mortality, operation data, and final diagnosis, were collected, and ISS, NISS and Trauma and Injury Severity Score (TRISS) were calculated. Mortality rate was 12.6%. The patients' mean GCS, RTS, ISS, NISS, and TRISS scores were 13.41+/-0.31, 10.65+/-0.26, 17.04+/-1.20, 21.94+/-1.45, and 9.52+/-2.37, respectively. The patients were divided into two groups as ISS=NISS (53.3%) and ISS ISS and NISS both performed well in mortality prediction of firearm injuries. NISS demonstrated no superiority to ISS for prediction of mortality in these patients.
Factors affecting mortality in patients with thorax trauma
(Türk Ulusal Travma ve Acil Cerrahi Dergisi, 2011) Emircan, Şadiye; Bulut, Mehtap; Özgüç, Halil; Akköse, Şule Aydın; Özdemir, Fatma; Köksal, Özlem; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; 0000-0003-2271-5659; AAK-8332-2020; 6603867989; 15757217900; 7006765911; 23389880200
BACKGROUND The purpose of this study was to define the epidemiologic properties and correlation of physiological and anatomical risk factors with the mortality rate among patients with thorax trauma and to ensure early prediction of severe trauma. METHODS Files of 371 cases were retrospectively examined. Their initial state in the emergency department was analyzed in terms of mortality development. Age, gender, trauma mechanism, systolic blood pressure and respiration type on admission, accompanying injuries, thorax pathology, trauma scores, and treatment approaches in exitus and surviving cases were compared. Survival probabilities and unexpected mortality rates were computed using the Trauma Revised Score-Injury Severity Score (TRISS). RESULTS Age, hypotension, pathologic respiration, blunt injury, accompanying injury, abdominal trauma, high Injury Severity Score (ISS), and low Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and TRISS were the factors affecting mortality, and presence of blunt injuries, TRISS <85, ISS >22 and GCS <13 were found to be independent prognostic factors. The strongest factor indicating mortality was TRISS. Thirty-four of 307 cases with survival probability of over 50% died. CONCLUSION In the presence of factors affecting mortality, patients with thorax trauma should be evaluated as being in a high-risk group and treatment strategies must be aggressive. Case analysis based on the TRISS model would further reveal the mistakes and may improve patient care.
Hemostatic effect of a chitosan linear polymer (Celox (R)) in a severe femoral artery bleeding rat model under hypothermia or warfarin therapy
(Ulusal Travma ve Acil Cerrahi Derneği, 2011) Köksal, Özlem; Özdemir, Fatma; Çametöz, Betül; İşbil Büyükcoşkun, Naciye; Sığırlı, Deniz; Tıp Fakültesi; İstatistik Ana Bilim Dalı; 0000-0003-2271-5659; AAK-8332-2020; AAH-1692-2021; AAA-7472-2021; 23389880200; 7006765911; 57215331517; 55665951400; 24482063400
In this study, the hemostatic efficacy of Celox (R) in rats under hypothermia or warfarin treatment was investigated. A total of forty-eight Sprague-Dawley female rats weighing 200-350 g were used in the study. Six experimental study groups were designed, as follows: Group 1: Normothermia + compression; Group 2: normothermia + Celox (R); Group 3: hypothermia + compression; Group 4: hypothermia + Celox (R); Group 5: normothermia + warfarin + compression; and Group 6: normothermia + warfarin + Celox (R). Celox (R) provided effective hemorrhage control in all three tested groups. There was a statistically significant difference between compression and Celox (R) implementation in all groups in terms of hemostasis (p-values for the normothermia, hypothermia and warfarin groups were p < 0.05, p < 0.01 and p < 0.01, respectively). Furthermore, the compression numbers were significantly lower in all of the groups that received Celox (R) than in those in which compression alone was applied (p-values for the normothermia, hypothermia and warfarin groups were p < 0.01, p < 0.01 and p < 0.001, respectively). Celox (R) provides effective hemorrhage control under conditions of normothermia, hypothermia and use of the oral anticoagulant agent warfarin.

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