BACKGROUND:Electrical injuries can lead to extensive tissue damage, particularly rhabdomyolysis, a severe clinical condition resulting from skeletal muscle breakdown. The McMahon score is a validated prognostic model used to predict acute kidney injury (AKI) and in-hospital mortality in rhabdomyolysis. However, its performance in cases specifically induced by electrocution remains unclear. METHODS:This retrospective observational study evaluated 173 adult patients admitted with electrocution-induced rhabdomyolysis between January 2019 and December 2023. Clinical and laboratory data, including McMahon scores calculated at admission, were extracted from medical records. Patients were categorized based on survival status, and statistical analyses assessed the relationship between McMahon scores and clinical outcomes, particularly mortality and AKI risk. RESULTS:The mean age was 29.4 ± 17.5 years; 80.9% were male. The median McMahon score was 3.0. In-hospital mortality was 3.5%. Patients who died had significantly higher McMahon scores (mean 7.4 vs. 3.4, P < .001). Receiver Operating Characteristic analysis revealed a strong predictive value for the McMahon score in mortality (area under the curve: 0.936; 95% confidence intervals: 0.876-0.997). A cut-off score of ≥6 yielded 83.3% sensitivity and 89.2% specificity. Mortality probability exceeded 90% when the score was ≥10. McMahon score was positively correlated with AKI risk percentage (r = 0.998, P < .001). CONCLUSIONS:The McMahon score is a robust prognostic tool for predicting in-hospital mortality in electrocution-induced rhabdomyolysis. A score ≥ 6 indicates increased risk, while lower scores are associated with favorable outcomes. These findings support the use of McMahon scoring for early risk stratification in emergency settings for electrically injured patients.

Climate change is no longer a distant threat but a present and escalating burden on emergency departments (EDs) worldwide. Its direct and indirect effects, ranging from heatstroke and hypothermia to vector-borne disease resurgence and mass casualty incidents, challenge conventional models of emergency preparedness. This narrative review explores the intersection of climate dynamics with ED operational and clinical vulnerabilities. We summarize five core physiological mechanisms by which temperature extremes disrupt homeostasis and review high-risk medication classes that may exacerbate heat-related morbidity. In addition, we examine the World Health Organization’s mass casualty triage framework and its relevance in climate-driven disasters such as floods, wildfires, and explosions. Special attention is given to low-resource settings and migration-heavy regions, where infrastructure strain and health inequity amplify the impact. We propose integrative, anticipatory planning models that combine clinical vigilance, environmental monitoring, and dynamic triage protocols. By identifying EDs as both front-line responders and sentinel systems, this study underscores the urgency of embedding climate resilience into emergency care strategies. Our synthesis aims to support clinicians, policymakers, and health systems in adapting emergency services to the realities of a warming world.

Lightning strikes are rare but potentially fatal environmental events that can lead to rhabdomyolysis through extensive muscle injury. This condition may result in serious complications such as acute kidney injury (AKI) and death. While the McMahon Score is a recognized prognostic tool in trauma-induced rhabdomyolysis, its effectiveness in lightning-related cases remains uncertain. This study aims to evaluate the prognostic utility of the McMahon Score in predicting mortality and the development of AKI in patients presenting with lightning strike-induced rhabdomyolysis. This retrospective cohort study included 66 patients admitted to a tertiary emergency department (ED) after lightning strikes between January 2013 and January 2023. Demographic, clinical, and laboratory data were reviewed. Patients were categorized by McMahon Score (≤ 6 and > 6). Outcomes such as mortality and AKI were compared. Predictive performance was assessed using ROC curve analysis. The median age was 21 years; 72.7

BACKGROUND:In natural disasters like earthquakes, building collapses can trap individuals, causing crush syndrome and rhabdomyolysis. This life-threatening condition often leads to acute kidney injury. We aimed to determine the effectiveness of the McMahon score in predicting mortality due to rhabdomyolysis in patients affected by the earthquake. METHODS:This is a retrospective observational study. In this study, the clinical and laboratory data of patients who presented to the emergency department due to the earthquake were analyzed. The McMahon score was calculated by evaluating factors such as creatine kinase, serum creatinine levels, age, and gender. RESULTS:The study included 151 patients, of whom 74 (49.0%) were male and 77 (51.0%) were female. In the univariate model, significant (P < .05) effectiveness was observed in differentiating between patients with and without mortality for McMahon score and the risk of acute kidney injury. At a McMahon score cutoff of 6, significant effectiveness was also observed, with an area under the curve of 0.723. At this cutoff value, the sensitivity was 80.0% and the specificity was 64.5%. CONCLUSIONS:The use of the McMahon score in emergency medicine and disaster management plays a crucial role in rapid decision-making processes due to its effectiveness in predicting mortality.

BACKGROUND:Pulmonary thromboembolism (PTE), often arising from deep vein thrombosis, remains a high-mortality condition despite diagnostic advancements. Prognostic models like Pulmonary Embolism Severity Index (PESI) and sPESI identify low-risk groups effectively. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, reflecting nutritional status and systemic inflammation, shows prognostic value in cancers and cardiovascular diseases. This study examines the relationship between in-hospital mortality HALP score and simplified PESI (sPESI) in PTE patients. METHODS:This retrospective observational study included patients diagnosed with PTE in the emergency department of a tertiary medical faculty from 2018 to 2023. PTE diagnosis was confirmed via computed tomography pulmonary angiography. Data on transthoracic echocardiography, D-dimer levels, demographics, laboratory results, PESI, sPESI, and HALP scores, and in-hospital mortality were collected. RESULTS:In this study, clinical characteristics of 171 patients with PTE were analysed. The average age was 61.88 ± 19.94 years, and 53.2% were female. Mortality was observed in 19.3% of patients. PESI and sPESI scores were significant predictors of mortality, with area under the curve values of 0.938 and 0.879, respectively. PESI score > 175.50 indicated a significantly higher mortality risk (HR = 18.208; P < .001), while sPESI >2.50 was also a strong predictor (HR = 11.840; P < .001). No significant cut-off value for HALP in predicting mortality was identified. CONCLUSIONS:Our study supports the reliability of sPESI and PESI scores in predicting in-hospital mortality in PTE patients. However, the prognostic value of the HALP score requires further investigation. Our findings highlight the need for developing risk stratification models. Key message What is already known on this topic? The PESI and sPESI scores are established prognostic models that effectively identify low-risk groups in patients with PTE. The HALP score, reflecting nutritional status and systemic inflammation, has shown prognostic value in cancer and cardiovascular diseases. What this study adds? This study demonstrates that while PESI and sPESI scores are significant predictors of in-hospital mortality in PTE patients, the HALP score does not have a significant cut-off value for predicting mortality. How this study might affect research, practice, or policy? The findings support the continued use of PESI and sPESI scores for risk stratification in clinical practice, potentially influencing guidelines and policies on managing PTE. Further research into the HALP score's role in other contexts may refine its prognostic utility.

Aim: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterized by symptoms such as cough, dyspnea, and airflow limitation. The prevalence and health risks of COPD increase with age, making emergency interventions crucial for elderly patients. This study investigated the influence of bilirubin, lactate clearance, and albumin levels on mortality rates among elderly COPD patients in emergency settings to inform treatment strategies and improve clinical outcomes. Material and Methods: Elderly patients diagnosed with COPD were included in this retrospective cohort study. Data on demographics, clinical presentations, laboratory results, comorbidities, and outcomes were collected. Biochemical measurements were performed via biochemical analyses and arterial blood gas analyses. Results: Among the 139 patients studied, 89 (64%) were male with a mean age of 75 years. The mortality rate was 7.92%. No significant differences were observed in age, sex distribution, or comorbidities between deceased and surviving patients. Lactate clearance and bilirubin levels did not significantly affect mortality. However, albumin levels were notably lower in deceased patients (p

An earthquake measuring 7.7 magnitude on the Richter scale occurred at 04:17am on February 6, 2023 in the Pazarcık district of Kahramanmaraş province Turkey. In the hours following the 7.7 magnitude event in Kahramanmaraş, a second 7.6 magnitude earthquake struck the region and a third 6.4 magnitude earthquake struck Gaziantep, causing extensive damage and death. A total of ten provinces directly experienced the earthquake, including Kahramanmaraş, Hatay, Gaziantep, Osmaniye, Malatya, Adana, Diyarbakır, Şanlıurfa, Adıyaman, and Kilis. The official figures indicate 31,643 people were killed, 80,278 were injured, and 6,444 buildings were destroyed within seven days of the earthquakes (as of 12:00pm/noon on Monday, February 13th). The area affected by the earthquake has been officially declared to be 500km in diameter. This report primarily relies on observations made by pioneer Emergency Physicians (EPs) who went to the disaster areas shortly after the first earthquake (in the early stages of the disaster). According to their observations: (1) Due to winter conditions, there were transportation problems and a shortage of personnel reaching disaster areas on the first day after the disaster; (2) On the second day of the disaster, health equipment was in short supply; (3) As of the third day, health workers were unprepared in terms of knowledge and experience for the disaster; and (4) The subsequent deployment of health personnel to the disaster area was uncoordinated and unplanned on the following days, which resulted in the health personnel working there not being able to meet even their basic needs (such as food, heating, and shelter). During the first week, coordination was most frequently reported as the most significant problem.

Amaç: İskemik ve hemorajik serebrovasküler hastalıklar, önemli bir morbidite ve mortalite nedenidir. Laktat klirensinin kritik hasta grubunda tüm mortaliteler ile ilişkili olduğu gösterilmiş. Biz bu çalışmada kritik hasta grubu içinde olabilecek inme ön tanılı hastalarda laktat ve laktat klirensinin prognozu tayin etmede yerini araştırmayı amaçladık. Yöntemler: 01.01.2018-31.12.2018 tarihleri arasında Dicle Üniversitesi acil servisine inme ön tanısıyla başvuran yaklaşık 300 hasta retrospektif olarak incelendi. Çalışma kriterlerine uyan 50 hastanın geliş anı laktat değeri, 24. saat laktat değeri ve 24. saat laktat klirensi değerlerine bakıldı. Çıkan sonuçların mortalite üzerine etkileri incelendi. Bulgular: Çalışmaya 50 hasta dahil edildi. Bu hastaların 23’ü erkek, 27’si kadındı. Hastaların yaş ortalaması 64,18±17.80 yıl olarak hesaplandı. Ölen hastaların 6’sı erkek, 13’ü kadın olup yaş ortalaması 66.11±19.95 yıl idi. Sağ kalan ve ölen hastalarımızın laktat düzeyleri ve laktat klirenslerine göre değerlendirildiğinde ölen hastalarımızda 24’üncü saatteki laktat düzeyi anlamlı derecede yüksektir Sonuç: İnme ön tanısıyla acile başvuran hastalarda laktat klirensinin prognoz tayini açısından iyi bir marker olamayacağı, 24. Saat laktat değerinin daha anlamlı olduğu ortaya çıktı.

This study was designed prospectively to investigate the demographic data of the patients who had blood and blood products in Dicle University Medical Faculty Research Hospital Emergency Service between 01 November 2014- 01 November 2015, also to investigate the indications for blood products used, the amount and the type of the products used. When we look at the diagnosis of patients who underwent transfusion in the emergency department; It was determined that 26.2% were transfused for malignancy, 32.6% for anemia, 18.3% for trauma, 12.5% for GIS bleeding, and 10.4% for other reasons. The patients who had blood product transfusion were 623; 53.8% were male and 46.2% were female. The mean age of the patients was determined 47.87±23.66. The percentage of transfused blood products were as following: 83.6% erythrocyte suspension (ES), 17.3% fresh frozen plasma (FFP), 17.3 % platelet suspension(PS), 0.6% whole blood(WB), %4.3 other blood components (OBC). As a result, we can say that in our study, a large number of transfusions were performed in the emergency department, a specific protocol was not adhered to in determining the indication, and transfusion was performed in support of patients who were mostly under outpatient follow-up. Emergency transfusion decisions should be performed with true emergency indication, follow-up with clinical response rather than laboratory response, and consciousness about the aim of transfusion.

Objective: Ethyl alcohol (EA) is a substance that is used commonly worldwide and known to have toxic effects on the liver The aim of this study was to investigate the effect of montelukast sodium (MK) on acute hepatopathy induced by a single dose of EA in rats. Methods: The study consisted of four groups each containing eight Wistar albino male rats. The groups were classified as follows: the control group received distilled water; the EA group received 6 g/kg EA diluted with distilled water orally by gavage; the MK group received 30 mg/ kg MK orally by gavage; the EA + MK group received, 2 hours after the EA administration, ie 30 mg/kg MK orally by gavage. After 24 hours, all the rats were sacrificed, and their blood and liver tissue samples were taken for biochemical and histopathological examinations. Results: The administration of EA caused a statistically significant increase in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels compared with the control group (220.50 +/- 66.90 and 92.38 +/- 5.90 versus 84.88 +/- 15.66 and 43.75 +/- 10.22). The administration of EA + MK caused a statistically significant decrease in the AST and ALT levels compared with the EA alone group. Ethyl alcohol administered to the rats caused lesion in the liver including congestions, hydropic degeneration and irregular shaped area caused coagulation necrosis. The histopathological changes seen in the EA group were not detected in the EA + MK group. Conclusion: Consequently, these data suggested that MK had beneficial effects in alleviating EA-induced hepatotoxicity in rats.

GİRİŞ ve AMAÇ: Kardiyak arrest tedavisinde yapılacak işlemlerin tamamı Kardiyopulmoner resüsitasyon (KPR) olarak adlandırılmaktadır. Tüm ölümlerin yaklaşık %20’si ani kardiyak arrest nedeniyle olmaktadır. Çalışmamızda hastane içi ve dışı kardiyak arestlerin özelliklerini tanımlamak ve sonuçlarımızı literatür ile karşılaştırmak amaçlandı. YÖNTEM ve GEREÇLER: Bu çalışmada 01.01.2013 ile 31.05.2015 tarihleri arasında acil servise başvuran tüm yaş gruplarında etyolojiden bağımsız olarak Kardiyopulmoner Resüsitasyon uygulanan hastalar retrospektif olarak incelendi. Tüm olgular yaş, cinsiyet, başvuru saati, komorbidite varlığı, biyokimyasal parametreler, kullanılan ilaçlar, hasta sonlanımı, yoğun bakım ihtiyacı, yatış sonrası hastanede kalış süreleri ve mortalite gibi sosyodemografik ve klinik özellikleri bakımından araştırıldı. TARTIŞMA ve SONUÇ: Tüm hastalarda HT varlığı sağ kalım lehine anlamlı iken, erkek cinsiyeti ve saat 06:01-12:00 arası başvuru mortalite lehine anlamlı bulundu. Hastane içi kardiyak arestte 21 dakika ve üzeri uygulanan KPR artmış mortalite ile ilşkili bulunmuştur. Kardiyopulmoner Resüsitasyonun kalitesini arttırmak amaçlı kayıt sistemlerinin ve standardizasyonun oluşturulması gerekliliği görülmektedir.

Amaç: İş: insanların yaşantısında onlara bir yer kazandıran önemli bir sosyal etmen olduğu gibi fiziksel, kimyasal, psikolojik, sosyal ve ekonomik pek çok nitelikleri ile de insan sağlığını etkilemektedir "1, 2". Sanayi devrimi ile birlikte etkilenen çalışma hayatına hemen her alanda makineleşme girmiş ve bu durum kitlesel üretime geçişle paralel başka sorunları beraberinde getirmiştir. Bu sorunların en başında ise iş kazaları gelmektedir. Çalışanlar; kullandıkları makineler, çalışma ortamındaki zehirli maddeler, insan yapısına uygun olmayan çalışma organizasyonu gibi nedenlerle çeşitli mesleki tehlikelerle karşılaşmaktadır "3". Bu nedenle her yıl azımsanmayacak sayıda insan, çok rahatlıkla engellenebilecek iş kazalarından ve meslek hastalıklarından yaşamını kaybetmekte veya engelli hale gelmektedir "4". Yöntemler: Bu çalışmada 1 Ocak 2013-31 Aralık 2015 tarihleri arasında meydana gelen iş kazaları geriye dönük olarak incelendi. Diyarbakır ili Dicle Üniversitesi Tıp Fakültesi Acil Tıp ve Travmatoloji Hastanesine başvuran hastaların arşivdeki dosyaları ile Sosyal Güvenlik Kurumu (SGK) kayıtlarına bakıldı. Çalışmaya dâhil edilen 406 olgunun yaş, cinsiyet gibi demografik özelliklerinin yanı sıra kazaların saat, gün, mevsim dağılımları gibi zamana bağlı başvuru şekilleri incelendi. Kazaların oluş yeri, acil servise başvuru şekli, kazanın oluş şekli, yaralanan organ, iş yeri özelliği, tedavi gördüğü ve/veya yattığı klinik ve sonuç parametreleri değerlendirildi. Bulgular: Araştırmaya dâhil edilen işçilerin %96,8’i (n=393) erkek, %3,2’si (n=13) kadındı. Olguların mevsimlere göre dağılımı en sık %30,8 (n=125) ile ilkbaharda görüldü. Hastalar en sık %34,7 (n=141) oranı ile 12-16 saatleri arasında başvurdu. Olgular %17,7 (n=72) ile en sık cumartesi günleri başvurdu. İş kazası nedeniyle acil servise başvuran hastaların kazanın olduğu yere göre dağılımları incelendiğinde; %99’unun (n=402) iş yerinde, %0,5’inin (n=2) evde çalışırken kazaya maruz kaldığı tespit edilirken, %0,5’inin (n=2) ise nerede kazaya maruz kaldığı tespit edilemedi. Sonuç: Çalışma yaşamının içindeki bir olgu olması nedeniyle iş kazaları, her şeyden önce üretim ilişkileri içindeki yeri, niteliği itibariyle değerlendirilmelidir. İş yerleri, kâr amacıyla kurulan yerler olduklarından, iş kazalarına karşı alınacak her türlü önlem bir maliyet konusudur. İş kazalarının bir diğer önemli niteliği ise önlenebilir oluşudur.

Amaç: İş: insanların yaşantısında onlara bir yer kazandıran önemli bir sosyal etmen olduğu gibi fiziksel, kimyasal, psikolojik, sosyal ve ekonomik pek çok nitelikleri ile de insan sağlığını etkilemektedir "1, 2". Sanayi devrimi ile birlikte etkilenen çalışma hayatına hemen her alanda makineleşme girmiş ve bu durum kitlesel üretime geçişle paralel başka sorunları beraberinde getirmiştir. Bu sorunların en başında ise iş kazaları gelmektedir. Çalışanlar; kullandıkları makineler, çalışma ortamındaki zehirli maddeler, insan yapısına uygun olmayan çalışma organizasyonu gibi nedenlerle çeşitli mesleki tehlikelerle karşılaşmaktadır "3". Bu nedenle her yıl azımsanmayacak sayıda insan, çok rahatlıkla engellenebilecek iş kazalarından ve meslek hastalıklarından yaşamını kaybetmekte veya engelli hale gelmektedir "4". Yöntemler: Bu çalışmada 1 Ocak 2013-31 Aralık 2015 tarihleri arasında meydana gelen iş kazaları geriye dönük olarak incelendi. Diyarbakır ili Dicle Üniversitesi Tıp Fakültesi Acil Tıp ve Travmatoloji Hastanesine başvuran hastaların arşivdeki dosyaları ile Sosyal Güvenlik Kurumu (SGK) kayıtlarına bakıldı. Çalışmaya dâhil edilen 406 olgunun yaş, cinsiyet gibi demografik özelliklerinin yanı sıra kazaların saat, gün, mevsim dağılımları gibi zamana bağlı başvuru şekilleri incelendi. Kazaların oluş yeri, acil servise başvuru şekli, kazanın oluş şekli, yaralanan organ, iş yeri özelliği, tedavi gördüğü ve/veya yattığı klinik ve sonuç parametreleri değerlendirildi. Bulgular: Araştırmaya dâhil edilen işçilerin %96,8’i (n=393) erkek, %3,2’si (n=13) kadındı. Olguların mevsimlere göre dağılımı en sık %30,8 (n=125) ile ilkbaharda görüldü. Hastalar en sık %34,7 (n=141) oranı ile 12-16 saatleri arasında başvurdu. Olgular %17,7 (n=72) ile en sık cumartesi günleri başvurdu. İş kazası nedeniyle acil servise başvuran hastaların kazanın olduğu yere göre dağılımları incelendiğinde; %99’unun (n=402) iş yerinde, %0,5’inin (n=2) evde çalışırken kazaya maruz kaldığı tespit edilirken, %0,5’inin (n=2) ise nerede kazaya maruz kaldığı tespit edilemedi. Sonuç: Çalışma yaşamının içindeki bir olgu olması nedeniyle iş kazaları, her şeyden önce üretim ilişkileri içindeki yeri, niteliği itibariyle değerlendirilmelidir. İş yerleri, kâr amacıyla kurulan yerler olduklarından, iş kazalarına karşı alınacak her türlü önlem bir maliyet konusudur. İş kazalarının bir diğer önemli niteliği ise önlenebilir oluşudur.

AIM:The aim of this study is to examine the role of the mean platelet volume (MPV), platelet distribution width (PDW), platelet/lymphocyte ratio (PLR), and platelet values for predicting mortality in patients with sepsis.MATERIALS AND METHODS:This is a retrospective study, involving patients 18 years and above who were diagnosed with sepsis. Blood samples were analyzed for platelets characteristics (counts, MPV, PDW, and PLR). The patients were separated into two groups namely the survivors and deceased. The two groups' MPV, PDW, PLR, and platelet counts which were considered to have an effect on mortality, were compared.RESULTS:Three hundred and thirty patients who were diagnosed with sepsis in our emergency department and complying with the study participation criteria were studied retrospectively. Comparison of the MPV, PDW, PLR, and platelet counts of the deceased and survivors showed that the MPV, PDW, and PLR were higher in the deceased while the platelet counts were higher in the survivors.CONCLUSION:The low number of platelets in patients with sepsis at the moment of application and the high PDW and PLR values are valuable for predicting a high mortality.

Aim: Patients presenting with chronic obstructive pulmonary disease (COPD) exacerbation in crowded emergency departments are often discharged with symptomatic treatment. This situation increases the number of patients admitted to the hospital and the number of attacks. It is very important to be able to predict hospitalization with cheap and easy blood parameters to be looked at the time of application. In our study, we aimed to investigate the relationship between lactate Clearance and admission or discharge decision in patients presenting with acute exacerbation of COPD.Methods: In this study, patients over 18 years old who were admitted to Batman Regional State Hospital Emergency Department with COPD attack between January 1, 2014 and January 1, 2018 were retrospectively studied. The patients were divided into 2 groups. Group 1 included the patients who discharged after treatment in emergency, group 2 included the patients who hospitalized. Both groups were compared in terms of lactate clearance values.Results: We studied 117 patients who met the criteria for inclusion in the study. Of these, 65 were discharged and 52 were hospitalized. Six of the hospitalized patients were hospitalized in the intensive care unit. Forty-one patients were female and 76 were male. We did not find any difference between the first and last lactate values of patients who were admitted and discharged (p=0.345 and 0.829). However, the lactate clearances of the discharged patients were higher, while the lactate clearances of patients with hospitalization indications were lower (p<0.001).Conclusion: We think that lactate clearance can be used as a marker in patients presenting emergency services with COPD exacerbation without deciding on discharge or admission.

Objective: There are a lot of studies searching parameters and markers which are effective on prognosis and mortality in subarachnoid haemorrhage. But there aren't any studies about the effectiveness of Neutrophil Lenfosit Ratio (NLR) on mortality.Materials and methods: In our study, former information of one hundred and thirty one patients who applying for varied complaints to our emergency service between January 2010 and April 2013 and diagnosed subarachnoid haemorrhage was analysed back and worked on study. The patients were categorized into two groups, namely the deceased and surviving groups.Results: The most frequent designated complaint was headache (51.1%). Anterior comminican artery anevrism was the most seen (28.2%) and the most mortal (38.8%) developed anevrism in subarachnoid haemorrhage. The conditions of patients who were unconscious in the course of applying developed more mortal. NLR was found 7.71 +/- 6.59 among survivor patients; 16.23 +/- 12.68 among dead patients. Neutrophil lenfosit rate was found considerably high among dead patients compared to survivor patients.Conclusion: In consequence, compared to other parameters Neutrophil lenfosit rate can be used as a simple, easy, and cheap parameter to guess short term prognosis and mortality. Doing more comprehensive and more studies will guide for the reason of high rates in NLR and the treatment of it.

Background: Changes in the physiology of patients over the age of 65 and additional internal pathologies cause them to be subject to trauma more often and change their ability to respond trauma. The purpose of this study is to make demographic analysis of geriatrics patients who apply to emergency service of Batman Regional State Hospital. Method: Our study involves patients over the age of 65 who applied to Batman Regional State Hospital in 1st February 2016-31st January 2017. 615 cases which were considered convenient with study criteria, had been examined retrospectively. The reason of application of cases, social demographic characteristics, specifications, additional diseases, the month of trauma, trauma area, trauma hour, mortality rates, GKS (Glasgow Coma Scale) and RTS (Revised Trauma Score) were obtained from automation system and case files. Results: 615 patients were included into study 252 of which were male and 363 were female. The average age of patients was 74.36. 70% of patients (n=433) were illiterate. The most common trauma was falling. Women patients were applied to service due to reason of falling than men. We used an anatomic scoring system called “Abbreviated Injury Scale (AIS)” and we divided patients into two groups as local and multiple according to the number of trauma areas. 58% (n=354) of patients were local cases while 42% (n=259) of them were multiple trauma cases and in both of the groups the most of affected body parts were extremities. In total, 6.17% (n=38) of patients were exitus. 11 of them died in emergency services. Most of patients died (78.94%) due to multiple trauma and they were mostly subject to traffic accidents. The most accompanying comorbid disease to deaths is hypertension. Conclusion: Both in our country and globally, the elderly population is increasing rapidly. The deaths due to trauma has a significant share in geriatric age group. Thus, it is significantly important to eliminate geriatric traumas and to intervene to the cases with multidisciplinary approach beginning from emergency services.

Objective: Laboratory parameters like NLR, PLR and PDW via using Alvarado scoring we aimed to predict and question the valuability these in the acute appendicitis diagnosis and acute appendicitis pathological subtype. Materials and methods: Between January 2013 and June 2015, 455 patients that their acute appendicitis diagnosis has been identified as a result of the pathological report and taken to operation with the suspicion of acute appendicitis and applied to Dicle University Medical Faculty. 114 patients that apply to our emergency service with other complaints excluding abdominal pain and who do not possess acute appendicitis have been registered as the control group. Regarding the NLR. PLR and PDW value both patient and control groups and patient group subtypes have been compared among each other. Results: In our patient group according to the control group WBC, neutrophil, NLR and PLR average values have been considered significantly high. Lymphocyte and PDW average values in the control group according to the patient group were significantly high. When compared regarding acute appendicitis types and control group NLR and PLR average values: in the perforated appendicitis group, when compared with both the control group and the other two appendicitis types a significantly high values have been detected. Conclusion: We will consider NLR, PLR and PDW values significant to diagnose acute appendicitis and to predict NLR and PLR value's acute appendicitis pathological subtype.

Objective: In this study we aimed to investigate the ap­plicability of Pediatric Emergency Care Applied Research Network (PECARN) rules for decision to perform computed cranial tomography (CCT) in pediatric patients with minor head trauma (MHT). Methods: 317 pediatric patients who underwent CCT for mild head trauma were evaluated retrospectively. The pa­tients were classified in two groups according to PECARN rules: below 2 years old, above 2 years old and then, these patient groups were classified into two subgroups accord­ing to the compatibility with PECARN rules. The patients re­quiring CCT according to PECARN rules were classified as PECARN compatible (PECARN +), the patients who under­went CCT without the need of CCT according to PECARN were classified as PECARN incompatible (PECARN -). Results: Approximately 20% patients in PECARN (+) group had abnormalities leading to prolonged hospitalization and only 3.8% patients of PECARN (-) group had abnormali­ties. However, none of PECARN (-) group patients required follow-up longer than 48 hours in the hospital. The most common symptoms necessitate CCT in PECARN (+) group were scalp swelling, scalp hematoma and vomiting. In PE­CARN (-) group the most common signs were cuts in the scalp and dermal abrasions. The incidence of fracture in CCT was significantly higher in PECARN (+) group. Conclusion: Because CCT poses serious radiation expo­sure, neurological examination and clinical follow-up should be preferred in the evaluation of children with MHT. In con­clusion, PECARN rules were sufficient for CCT decision in pediatric patients with MHT.