Browsing by Author "Irik M."

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    Combination of mean platelet volume and the CURB-65 score better predicts 28-day mortality in patients with community-acquired pneumonia
    (W.B. Saunders, 2015) Golcuk Y.; Golcuk B.; Bilge A.; Irik M.; Dikmen O.
    Objective: This study aims to investigate whether mean platelet volume (MPV) is correlated with the CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, > 65 years of age) score, and whether a combination of the CURB-65 score with MPV could better predict the 28-day mortality in patients with community-acquired pneumonia (CAP). Methods: This prospective, observational, single-center, and cross-sectional study was conducted at emergency department (ED) between September 1, 2013, and July 31, 2014. All patients underwent follow-up evaluations 28 days after admission. The end point was defined as all-cause mortality. Results: A total of 174 patients (mean age, 66.7 ± 15.8 years; 66.1% men) with CAP were enrolled in this study. All-cause mortality at the 28-day follow-up evaluation was 16.1%. A significant and inverse correlation between MPV and CURB-65 score was found (R = -.58, P <.001). We determined that the optimal MPV cutoff for predicting 28-day mortality at the time of ED admission was 8.55 fL, with a 75.0% sensitivity and a 75.3% specificity. For the prediction of 28-day mortality, the area under the receiver operating characteristic curve was 0.819 (95% confidence interval [CI], 0.740-0.898; P <.001) when the CURB-65 score was used alone, whereas it increased to 0.895 (95% CI, 0.819-0.936; P <.001) with the addition of MPV to the score. Conclusions: Mean platelet volume level is valuable for predicting mortality and the severity of disease among patients with CAP at ED admission. Furthermore, a combination of CURB-65 score and MPV can enhance the predictive accuracy of 28-day mortality. © 2015 Elsevier Inc.
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    Prognostic value of serum pregnancy-associated plasma protein A level at the initial ED presentation in elderly patients with CAP
    (W.B. Saunders, 2015) Golcuk Y.; Golcuk B.; Bilge A.; Korkmaz A.; Irik M.; Hayran M.; Ozdemir A.T.; Kurtulmus Y.
    Objective This study aims to compare serum pregnancy-associated plasma protein A (PAPP-A) levels in surviving and nonsurviving elderly patients with community-acquired pneumonia (CAP), investigating whether PAPP-A is correlated with CAP prediction scores and whether PAPP-A can successfully predict 28-day mortality rates in elderly patients. Methods This prospective, observational, single-center, cross-sectional study was conducted at the emergency department (ED) of Celal Bayar University Hospital in Manisa, Turkey, between January and September 2014. All patients underwent follow-up evaluations 28 days after admission. The end point was defined as all-cause mortality. Results A total of 100 elderly patients (mean age, 77.3 ± 7.6 years [range, 65-94 years]); 60% men) with CAP were enrolled in this study. All-cause mortality at the 28-day follow-up evaluation was 22%. Admission PAPP-A levels were significantly higher in nonsurvivors compared with 28-day survivors (10.3 ± 4.5 vs 3.8 ± 2.6 ng/mL, P <.001). A significant and positive correlation between admission PAPP-A levels and pneumonia severity index; confusion, oxygen saturation, respiratory rate, blood pressure, and age 75 years or older; and confusion, urea, respiratory rate, blood pressure, and age older than 65 years scores was found (r =.440, P <.001; r =.395, P <.001; and r =.359, P <.001, respectively). Moreover, we determined that the optimal PAPP-A cutoff for predicting 28-day mortality at the time of ED admission was 5.1 ng/mL, with 77.3% sensitivity and 77.9% specificity. Conclusions Serum PAPP-A level is valuable for predicting mortality and the severity of the disease among elderly patients with CAP at ED admission. Thus, PAPP-A might play a further role in the clinical assessment of the severity of CAP. © 2015 Elsevier Inc.
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    Diagnosis of delayed diffuse axonal İnjury
    (W.B. Saunders, 2017) Kokkoz Ç.; Irik M.; Dayangaç H.I.; Hayran M.; Bilge A.; Çavuş M.
    Diffuse axonal injury is usually caused by head trauma, and patients have significant clinical symptoms during admission to the emergency department. In our case, we present a five-year-old patient who was involved in a car accident. During admission to the emergency department, the patient had no symptoms of trauma. However, 6 h after admission to emergency service, neurological symptoms occurred, and mental status changed. Diffuse axonal injury (DAI) is characterized by diffuse nerve axon injury in the brain and brainstem. This is one of the worst results of a head trauma and occurs in one-third of the patients admitted to the hospital with head trauma. In some studies, it has been reported that diffuse axonal injury is permanent in accelerated and decelerated head traumas without accompanying loss of consciousness. Neurological sequels have occurred in the recovery phase of some patients with diffuse axonal damage. In this study, we present a delayed diffuse axonal injury case accompanying a head trauma. © 2017 Elsevier Inc.
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    Prognostic value of plasma ST2 in patients with non-ST segment elevation acute coronary syndrome
    (Emergency Medicine Association of Turkey, 2018) Kokkoz Ç.; Bilge A.; Irik M.; Dayangaç H.I.; Hayran M.; Akarca F.K.; Erdem N.B.; Çavuş M.
    Objective: The aim of this study is to detect plasma ST2 levels in patients who were admitted to emergency department with chest pain and diagnosed with non st segment elevation myocardial infarction (NSTEMI) and to research the relationship between 28-day mortality and ST2 levels. Methods: The present study was conducted at Emergency Department of Celal Bayar University Hafsa Sultan Hospital between September 2015 and January 2016 as a prospective, single-center, cross-sectional study. Plasma ST2 levels were detected in patients who were diagnosed with NSTEMI based on physical examination, ECG and troponin. The eligible patients were followed up with regard to mortality during 28 days. Results: A total of 88 patients diagnosed with NSTEMI were included in the study and followed up for 28 days. While 18 (20.5%) patients died at the end of 28 days, 70 (79.5%) patients survived. Mean ST2 level of surviving 70 patients was 651.37 ± 985.66 pg/mL and mean ST2 level of dying 18 patients was 2253.66 ± 1721.15 pg/mL (p < 0.001). ST2 value was higher among the dying (non-survivors) compared to the survivors at the end of 28 days and this was found related to mortality. ST2 cut-off value was found as 1000 pg/mL with 72.2% sensitivity and 20.0% specificity. Conclusion: Among the patients who were diagnosed with NSTEMI at the emergency department, ST2 levels on admission were found significantly higher among the non-survivors compared to the survivors. ST2 level was accepted as a reliable biomarker for prediction of 28 mortality in patients diagnosed with NSTEMI. © 2018 The Emergency Medicine Association of Turkey