Base excess is superior to creatinine in predicting haemodialysis: A multicenter study conducted Kahramanmaras earthquake victims.

PURPOSE: This study had two main goals: to determine which rhabdomyolysis patients need haemodialysis; and to highlight the significance of blood gas parameters, particularly base excess, as predictors of the need for haemodialysis. METHOD: A total of 270 patients were included in this multicentre, retrospective study. Among the patients who were transferred in from the earthquake region and developed rhabdomyolysis, those with creatine kinase (CK) values >1000 U/L were included in our study. The need for renal replacement in these patients was determined via laboratory tests, urine output monitoring and clinical follow-up. FINDINGS: A total of 270 patients were included in our study. Univariate and multivariate regression analyses of laboratory parameters were performed to identify predictors of HD treatment. According to the univariate regression analysis, BE, HCO3, creatinine, CK, lactate, alanine transaminase (ALT) and aspartate transaminase (AST) levels were found to be significantly associated with receiving HD treatment. According to multivariate regression analysis, only BE (p = 0.003) was found to be a significant predictor of HD treatment. ROC analysis revealed that the optimal cutoff value for BE was -2.6; at this value, the sensitivity and specificity of BE for predicting HD treatment were 89% and 77.1%, respectively (AUC: 0.912; 95% CI: 0.872-0.943; p < 0.001). CONCLUSION: Base excess is an effective predictor of the need for haemodialysis in patients with crush-related injuries that cause rhabdomyolysis and in patients who develop acute renal failure due to elevated CK.

Comparison of optical coherence tomography angiography results in patients with internal carotid artery stenosis who underwent carotid artery stenting and carotid endarterectomy.

It is important to examine the ocular hemodynamic changes after carotid artery stenting (CAS) and carotid endarterectomy (CEA) in patients with internal carotid artery stenosis (ICAS). We aimed to compare the differences in retinal and optic nerve head blood flow after 2 surgical methods. The ipsilateral eyes of 34 patients who had over 50% ICAS with no ocular findings and 30 healthy controls were included in the study. Foveal avascular zone vessel density in the superficial retinal capillary plexus, deep retinal capillary plexus (DCP), and radial peripapillary capillary plexus (RPCP) were measured with an optical coherence tomography angiography device. These measurements were repeated 1 month after CAS or CEA in patients with ICAS. The preoperative and postoperative values of the patients were compared both within themselves and with the control group. When patients with ICAS were compared with the control group, lower vessel density values were found in the DCP parafovea, RPCP whole image, and peripapillary regions both before and after the procedure. There was no significant difference in terms of other parameters. Furthermore, there was no significant difference in any parameter examined between the pre- and postprocedural values of the patients who underwent CAS and CEA. DCP and RPCP are mostly affected in patients with ICAS. We observed that after application of the CAS and CEA methods, the effects on ocular blood flow were similar.

Interpretation of acid-base metabolism on arterial blood gas samples via machine learning algorithms.

BACKGROUND: Arterial blood gas evaluation is crucial for critically ill patients, as it provides essential information about acid-base metabolism and respiratory balance, but evaluation can be complex and time-consuming. Artificial intelligence can perform tasks that require human intelligence, and it is revolutionizing healthcare through technological advancements. AIM: This study aims to assess arterial blood gas evaluation using artificial intelligence algorithms. METHODS: The study included 21.541 retrospective arterial blood gas samples, categorized into 15 different classes by experts for evaluating acid-base metabolism status. Six machine learning algorithms were utilized; accuracy, balanced accuracy, sensitivity, specificity, precision, and F1 values of the models were determined; and ROC curves were drawn to assess areas under the curve for each class. Evaluation of which sample was estimated in which class was conducted using the confusion matrices of the models. RESULTS: The bagging classifier (BC) model achieved the highest balanced accuracy with 99.24%, whereas the XGBoost model reached the highest accuracy with 99.66%. The BC model shows 100% sensitivity for nine classes and 100% specificity for 10 classes, and the model correctly predicted 6438 of 6463 test samples and achieved an accuracy of 99.61%, with an area under the curve > 0.9 in all classes on a class basis. CONCLUSION: The machine learning models developed exhibited remarkable accuracy, sensitivity, and specificity in predicting the status of acid-base metabolism. However, implementing these models can aid clinicians, freeing up their time for more intricate tasks.

D-dimer/high sensitive troponin I ratio is useful in predicting in-hospital mortality in pulmonary embolism patients.

BACKGROUND: Pulmonary embolism requires careful differential diagnosis as it is associated with a wide range of symptoms that may suggest different diseases such as chest pain, shortness of breath and syncope. Since the disease can be fatal, especially in cases where right ventricular failure and hemodynamic instability develop, prognostic markers are great importance in terms of monitoring the patient during the treatment process. AIM: We aimed in our study to compare the relationship between the ratio of D-dimer and High Sensitive Troponin T (HsTnT) values ​​with short-term mortality and to compare this relationship with Pulmonary Embolism Severity Index (PESI) scoring. METHOD: Our study was conducted with patients who applied to the emergency department of our hospital between 01/01/2022 and 01/01/2023 and were definitively diagnosed with Pulmonary thromboembolism after their evaluation. FINDINGS: The success of D-dimer/HsTroponin, D-dimer/CK-MB and troponin/D-dimer indices calculated from the laboratory test results of the cases in predicting mortality was examined, and a comparison was made with the success of the PESI score in predicting mortality. Among these indices, D-dimer/CK-MB was found to be the most successful index in predicting 7-day mortality (AUC: 0.734; 95% CI: 0.653-0.815; p < 0.001). Additionally, the D-dimer/HsTroponin ratio was found to be statistically significant as a successful index in predicting 7-day mortality (AUC: 0.697; 95% CI: 0.621-0.774; p < 0.001). CONCLUSION: FD-dimer/HsTroponin ratio, which is a powerful, fast, low-cost, easy and simple test, can be used especially in emergency services instead of the PESI score as a mortality marker in pulmonary embolism, which has a high mortality rate.

Prognostic relationship between high sensitivity troponin I level, hematoma volume and glasgow coma score in patients diagnosed with spontaneous intracerebral hemorrhage.

BACKGROUND: Intracranial hemorrhages is one of the major causes of mortality and morbidity worldwide, and there is still no effective biomarker to predict prognosis. AIM: We aimed to determine the effectiveness of high sensitive troponin I (hs-cTn-I) levels to predict the prognosis of spontaneous intracerebral hemorrhage (sICH) by comparing Glasgow Coma Score (GCS) and hematoma volume with hs-cTn-I levels. METHODS: This study was planned as a retrospective observational study. Patients with available data, over 18 years old and sICH were included in the study. Cerebral computed tomography images were evaluated by a senior radiologist. Hematoma volume was calculated using the ABC/2 formula. RESULTS: The study comprised 206 individuals in total 78 (37.86%) women and 128 (62.13%) men. Forty-four (21.35%) of patients died. The sensitivity of GCS, hs-cTn-I, and hematoma volume values were 86.36%, 66.67%, and 59.46%, respectively, with corresponding specificities of 78.75%, 93.02%, and 87.58%. Patients with hs-cTn-I values over 26, GCS values of ≤ 9, and hematoma volume values above 44.16 were found to have higher risk of mortality (p = 0.011; p < 0.001; p < 0.001, respectively). The mortality rates were found to be increased 2.586 (IQR: 1.224-5.463) times in patients with hs-cTn-I values above 26, 0.045 times (IQR: 0.018-0.115) in patients with GCS values ≤ 9, and 7.526 times (IQR: 3.518-16.100) in patients with hematoma volume values above 44.16. CONCLUSIONS: Our findings suggest that hs-cTn-I values exceeding 26 units may serve as effective biochemical markers for predicting the prognosis of patients with sICH.

Prognostic value of systemic immune-inflammation index in the diagnosis of preeclampsia.

Background: Preeclampsia is a serious complication of pregnancy with negative consequences for the mother and fetus. It was aimed to investigate whether the systemic immune inflammation index is a parameter that will facilitate the diagnosis of preeclampsia. Methods: This retrospective and single-center study included patients diagnosed with preeclampsia after admission to the emergency department and those who met the inclusion criteria. Vital parameters, demographic data, medical history, white blood cell count, platelet count, neutrophil count, systemic immune-inflammation index values, biochemical parameters, and gestational weeks were analyzed in each patient. Results: A total of 40 patients with preeclampsia (preeclampsia group) and 40 normal pregnant women (control group) were included. Laboratory tests revealed that the mean WBC, neutrophil, and lymphocyte counts were significantly higher in the preeclampsia group than in the control group, whereas the preeclampsia group had a significantly lower mean platelet count than the control group (p < 0.001). The sensitivity and specificity for the cut-off value of 758.39 × 109/L systemic immune-inflammation index in pregnant patients with preeclampsia was 77.5% and 67.5%, respectively (AUC: 0.705; 95% CI: 0.587-0.823; p = 0.002). No significant difference was observed between the mean neutrophil-to-lymphocyte ratio in preeclampsia diagnosis. Conclusion: The systemic immune-inflammation index may be used as a marker to help in establishing the diagnosis of preeclampsia. We believe that this index is an important prognostic indicator because it concurrently evaluates neutrophil and lymphocyte values-which indicate the inflammation process-and platelet count, i.e., an indicator of coagulopathy.

Comparison of Manchester, qSOFA, emergency severity index, and national early warning scores for prognostic estimation and effective triage system in geriatric patients.

BACKGROUND: Triage refers to classifying and prioritizing patients based on the severity of their injuries or illnesses in the health care setting. The increasing number of elderly patients seeking care in emergency departments (EDs) highlights the need for special attention to the unique needs of this patient population. AIM: We aimed to compare the qSOFA, Emergency Severity Index (ESI), National Early Warning Score (NEWS), and Manchester Triage System (MTS) scores to assist ED physicians in assessing the severity of elderly patients' clinical conditions and triaging them appropriately. METHODS: This cross-sectional study included 1066 patients aged 65 and over who presented to our ED as outpatients or by ambulance between September 1, 2022, and August 30, 2023. Scoring systems at the time of admission to the ED were recorded separately for outpatients and arriving by ambulance. RESULTS: According to the qSOFA, patients with a score of 0 were 0.976 times less likely to arrive by ambulance compared to those scoring 1 and above (OR = 0.976, p = .934). According to the NEWS, patients in the moderate-risk category were 0.447 times less likely to arrive by ambulance (OR = 0.447, p = .054). According to the ESI score, patients requiring high resource use with normal vital signs were 146.758 times more likely to arrive by ambulance (OR = 146.758, p = .001). CONCLUSION: Significant differences in patients' methods of presentation to the ED were observed based on the MTS, qSOFA, NEWS, and ESI scores.

Analysis of postoperative emergency admission and hospitalization of patients who underwent bariatric surgery: A single-center experience.

BACKGROUND: Bariatric surgery is a treatment with a low risk of complications that is becoming common in obesity treatment. OBJECTIVE: The aim of this study is to evaluate postoperative visits to the emergency department by patients who underwent bariatric surgery and to investigate what postoperative conditions are encountered in these patients and what can be done to prevent emergency room admission and hospitalization. SETTING: University Hospital. METHODS: The study included 394 patients aged 18 years underwent bariatric surgery for obesity. Emergency department (ED) admissions and diagnoses of patients who underwent bariatric surgery were analyzed in two groups, surgery-related and surgery-unrelated. RESULTS: It was found that 22% (n: 87) of patients visited the ED at least once; 4.8% (n: 19) of them were hospitalized; and 78.1% (n: 68) of 87 patients did not need to be hospitalized. Low preoperative iron, folic acid, and ferritin levels increase the number of visits to ED with a bariatric surgery-related complaint, urinary tract infection was the most common diagnosis and did not require hospitalization; the most common diagnosis of hospitalized patients was gastrointestinal perforation, pulmonary embolism, intra-abdominal abscess. CONCLUSION: Despite the low risk of complications, bariatric surgery is a surgery associated with a high number of preventable postoperative emergency visits. ED visits can be reduced by calling these patients for more frequent outpatient check-ups, providing intravenous hydration therapy in outpatient clinics and, if necessary, providing prescribed treatment.

Composite graft repair in distal finger injuries: emergency room or operating room?

BACKGROUND: Fingertip amputations are common injuries presenting to the emergency room. However, all amputations do not have a chance of replantation, and composite graft is among the salvage treatments in this case. This treatment is both easy to apply and economical. Our study compares the success and cost of composite grafting in the emergency and operating rooms. METHODS: Thirty-six patients who met the criteria were included in the study. The decision on the repair site was made by the sur-geon according to patient compliance and the intensity of the emergency clinic. Demographic and disease information of the patients were recorded. P<0.05 was accepted as the significance level. RESULTS: Twenty-two cases were pediatric patients. Eighteen cases of crush injuries and 22 cases were treated in the emergency room. There was no significant difference in terms of complications, need for additional intervention, and short fingers related to interventions performed in the emergency room and operating room. Interventions in the emergency department were significantly lower in cost and shorter hospitalization times. There was no significant difference in terms of patient satisfaction. CONCLUSION: Composite grafting is a simple and reliable method in fingertip injuries and gives satisfactory results in terms of patient satisfaction. In addition, composite graft application in fingertip injuries in the emergency department will both reduce the cost and prevent hospital infections that may occur due to the reduction in hospitalization.

Prognostic Importance of Lactate and Blood Gas Parameters in Predicting Mortality in Patients with Critical Malignancies.

Background: The aim of the present study was to detect the prognostic importance of lactate and other blood gas parameters for mortality prediction in patients with critical malignancies referring to the emergency service. The general condition of patients with malignancy who have referred to the emergency department should be evaluated and it should be shown that they are not in any oncological emergency. It is a highly significant predictor of mortality after sepsis and shock in hyperlactatemia accompanying metabolic acidosis. It is significantly used for treatment monitoring. Methods: This study was planned prospective and observational study. The patients enrolled were divided into two groups including survivor and non-survivor depending on 30-day mortality. The primary outcome of the study was determined as following the mortality within 30 days. Results: The mean lactate level was 1.9 (1.4-2.5) mmol/L in the survivor group, and 2.6 (1.9-4.4) mmol/L in the non-survivor group; a significant difference was obtained between both groups (p<0.001). When the cut-off value of the lactate was determined as >2.95 mmol/L in order to differentiate the survivors from non-survivors, the sensitivity and specificity were detected as 35.0% and 86.1%, respectively. It was detected by the multivariate regression analysis that lactate predicts the 30-day mortality with a higher significance level in patients with critical malignancies. Conclusions: It was concluded that lactate is a good predictor and may be used safely in predicting 30-day mortality in patients with any critical malignancy referring to the emergency department.

Serum Periostin Levels are Significantly Higher in Patients with Primary Hyperparathyroidism and Closely Related to Osteoporosis.

BACKGROUND: Periostin is an emerging biomarker that plays a role in bone metabolism and may be associated with bone mineral density (BMD). This study is aimed to investigate serum periostin levels in patients with primary hyperparathyroidism (PHPT) and its correlation with BMD in these patients. METHODS: Forty patients with newly diagnosed PHPT without co-morbidities and 30 healthy controls were included. Laboratory tests for the diagnosis of PHPT and serum levels of periostin were measured for all patients. BMD was measured on lumbar spines L1 and L4 by dual-energy X-ray absorptiometry (DEXA). Serum periostin levels were detected using an enzyme-linked immunosorbent assay (ELISA). RESULTS: Serum periostin levels were significantly higher in patients with PHPT than in healthy controls (p<0.001). Serum periostin levels were also significantly higher (mean 59.7±11.0 ng/mL) in PHPT patients with osteoporosis than those without osteoporosis (p=0.004). In logistic regression analysis, only serum periostin levels independently predicted the patients with osteoporosis. According to this analysis, every 1 ng/mL increase in serum periostin increased the risk of having osteoporosis by 20.6%. When the cut-off for serum periostin level was 49.75 ng/mL, the patients with osteoporosis were predicted with 71.4% sensitivity and 69.2% specificity. Multivariate regression analysis revealed a negative correlation between serum periostin levels and L1-L4 T scores on DEXA. CONCLUSION: This is the first study to determine that serum periostin levels are higher in PHPT patients than those without PHPT and to demonstrate a significant association between serum periostin levels and T scores on DEXA in patients with PHPT. These findings will aid in detecting osteoporosis in patients with PHPT and making the decision for surgery in PHPT patients with no need for DEXA imaging that involves radiation.

Lactate for Predicting the Prognosis of Multi-Drug Poisoned Patients.

Background: We aimed to compare serum lactate levels of multi-drug poisoned patients to determine whether knowing the level may help emergency clinicians in predicting the patients' prognoses. Methods: The patients were divided into two groups according to the number of kinds of drugs taken (Group 1: patients took 2 kinds of drugs; Group 2: patients took 3 or more kinds of drugs). The groups' initial venous lactate levels, lactate levels before discharge, lengths of stay in the emergency department, hospitalisation units, clinics, and outcomes were recorded on the study form. These findings of the patient groups were then compared. Results: When we evaluated the first lactate levels and lengths of stay in the emergency department, we found that 72% of the patients with initial lactate levels ≥13.5 mg/dL stayed more than 12 hours in the emergency department. Twenty-five (30.86%) patients in the second group stayed ≥12 hours in the emergency department, and their mean initial serum lactate level was significantly related (p=0.02, AUC=071). The mean initial serum lactate levels of both groups were positively related with their lengths of stay in the emergency department. The mean initial lactate levels of patients who stayed ≥12 hours and those who stayed <12 hours in the second group were statistically significant, and the mean lactate level of the patients who stayed ≥12 hours in the second group was lower. Conclusions: Serum lactate levels may be helpful in determining a patient's length of stay in the emergency department in the case of multi-drug poisoning.

Transient ischemic liver injury and respiratory failure in a COVID-19-positive patient after multiple bee stings.

We present a patient with multiple bee stings who developed lung and liver injuries and subsequently tested positive for coronavirus disease 2019 (COVID-19). A 65-year-old male patient presented to the emergency department after being stung by more than 100 honeybees. His physical examination revealed pustular lesions distributed across his chest, arms, back, legs, and head, marking the sting zones. While the patient had no history of liver disease, initial laboratory test results showed elevated liver enzyme levels. A chest computer tomography scan was ordered, revealing bilateral ground-glass opacities suggesting COVID-19. His condition worsened over the course of the following day, and when he was admitted to the intensive care unit (ICU), his SpO2 decreased to 83% despite oxygen support with a mask. The second polymerase chain reaction test taken in the ICU was positive for COVID-19 infection. After stung with multiple bees, the patient developed acute liver injury and suffered from concomitant COVID-19-related respiratory insufficency, and he was treated accordingly. Starting on the 5th day, the patient's liver markers began to improve, and on the 13th day, he was discharged with normal vital signs and liver enzyme values. There seem to be varying outcomes across different studies with regard to the relationship between bee stings and COVID-19. Further research is needed to explore the possibility of this complementary treatment with bee venom in the prevention of severe acute respiratory syndrome coronavirus-2 infection.

Humoral responses to the CoronoVac vaccine in healthcare workers.

BACKGROUND: This study aimed to assess the immunoglobulin G (IgG) antibody response rate in emergency department (ED) healthcare workers (HCWs) and potential adverse effects after CoronaVac vaccination. METHODS: All included HCWs were grouped based on the previous history of coronavirus disease 2019 (COVID-19) and the number of vaccinations. Furthermore, the IgG antibody response was evaluated based on the sex and smoking status of HCWs. Those with a cut-off index of ≥1.00 after vaccination with CoronaVac were considered to have had COVID-19 and had an adequate humoral response. RESULTS: Among 224 ED HCWs, 18% experienced the adverse effects of CoronaVac vaccine, the most prevalent being pain in the injection site. The IgG antibody response rate was 20% after the first dose of vaccine, while the response rate increased to 90% after the second dose. Female HCWs had higher IgG response rates compared with male HCWs (53.8 [15.9-147.0] vs 31.2 [4.5-124.0]). Non-smokers had higher IgG response rate compared with smokers (49.0 [11.5-160.5] vs 23.1 [7.4-98.5]). CONCLUSION: A single dose of CoronaVac does not produce a sufficient antibody response; hence, two doses are recommended. Men have a lower IgG response compared with women. Smokers had a lower IgG response rate compared with non-smokers. Therefore, it may be necessary to carefully assess the humoral responses of men and smokers when implementing a community vaccination program.

Serum Elabela level is significantly increased in patients with acromegaly.

BACKGROUND: Although the bioactive peptides associated with the apelinergic system are known to be associated with heart failure and ischemic heart disease, there are no data on their association with acromegaly. AIM: We aimed to investigate the change in serum Elabela levels, a novel peptide of the apelinergic system, in patients with acromegaly. METHODS: Our study included 30 treatment naive patients who were recently diagnosed with acromegaly, and 50 age-and-sex-matched healthy controls. In addition to routine history, physical examination and laboratory examinations, serum Elabela level was measured. Participants were divided into two groups as individuals with and without acromegaly and compared to each other. RESULTS: Diastolic blood pressure (DBP) and systolic blood pressure (SBP) were found to be higher in patients with acromegaly. Serum glucose, Hs-CRP, NT-proBNP, insulin-like growth factor-1, growth hormone and serum Elabela levels were higher in patients with acromegaly (p < 0.05 for each). Left ventricular ejection fraction (LV-EF) was found to be lower in patients with acromegaly than the patients in healthy control group (p < 0.05). In multivariate analysis; age, systolic blood pressure, NT-proBNP, Insulin-like growth factor 1 and growth hormone levels were found to be very closely and positively related to serum Elabela level (p < 0.05 for each). CONCLUSIONS: Serum Elabela level can be used as an early and objective indicator of early cardiovascular involvement in patients with acromegaly. Further research is needed to clarify the role of serum Elabela levels on cardiovascular system in acromegaly patients.

The relationship between infarct volume and high sensitivity troponin I level in patients diagnosed with ischemic stroke.

BACKGROUND: Various biomarkers and clinical variables are used to determine the probability risk, diagnosis, and the prognosis of acute ischemic stroke, but effective markers are still warranted. AIM: We aimed to determine the effectiveness of Hs-cTnI levels to predict the prognosis of AIS. METHODS: This study was planned as a retrospective observational study. Patients with available data and over 18 years old were included in the study. Diffusion magnetic resonance images were evaluated by a senior radiologist and the infarct size was calculated. RESULTS: We included 110 (54.2%) males and 93 (45.8%) females; a total of 203 patients with a mean age of 68.9 were included in the present study. Patients were divided into two groups according to the cut-off level of Hs-troponin-I (group I: lower than 8.5 mg/dL; group 2: higher than 8.5 mg/dL). These two groups were compared for mortality and infarct volume. Infarct volume and the mortality ratio of the group 2 was significantly higher [p = 0.041, U = 4294.5, LV = 6.5 (IQR = 1.8-25.4)]. CONCLUSIONS: Hs-troponin I may be an effective biomarker in predicting the prognosis of patients with acute ischemic stroke. Multicenter comprehensive prospective studies are warranted to obtain stronger results.

Revised Trauma Score and CRAMS better predicted mortality in high-energy-trauma patients than Early-Warning Score.

BACKGROUND: Trauma is one of the common reasons for emergency department (ED) presentations. Specifically, severe-trauma patients often present with mortal complications, including traumatic shock or respiratory or multiorgan failure/dysfunction, and these situations cause high-mortality risk. Scoring systems in the triage of trauma patients can help determine the injury's severity and the patient's prognosis. AIM: In this study, we aimed to compare Early-Warning Score (EWS), Revised Trauma Score (RTS), and CRAMS to predict the severity and prognosis of damage among high-energy-trauma patients. METHODS: This retrospective study included adult high-energy-trauma patients (> 18 years of age) assessed in our emergency department (ED) from April 1, 2020, to September 31, 2020. We included a total of 177 high-energy-trauma patients in the study. We compared the effectiveness of EWS; RTS; and circulation, respiration, abdomen, motor, and speech (CRAMS) in predicting mortality. The primary outcome of this study was mortality. RESULTS: We included 67 females and 110 males with a mean age of 39.2 in our study. Of those patients, 6 died during ICU hospitalization and 104 were discharged from the ward. RTS (AUC: 0.978, CI: 0.945-0.994, p < 0.001) and CRAMS (AUC: 0.978, CI: 0.944-0.994, p < 0.001) had the same AUC values, but the AUC value of EWS (AUC: 0.966, CI: 0.927-0.987, p < 0.001) was lower. Sensitivity of EWS was 93.1 (CI: 77.2-99.2%), and sensitivity of RTS was 96.55 (CI: 82.2-99.9) and CRAMS' sensivity was 96.55% (CI: 82.2-99.9). RTS showed the highest specivity level (96.62%, CI: 92.3-98.9). CONCLUSION: In conclusion, RTS and CRAMS better predicted mortality in high-energy-trauma patients than EWS.

Evaluation of diagnostic efficiency of bedside cardiac ultrasonography performed by emergency specialist.

BACKGROUND: In emergency medicine, ultrasound is frequently used in the diagnostic and therapeutic procedures and evaluation of treatment of critically ill patients simultaneously, due to its bedside applicability, rapidness and inexpensive cost. AIM: The competence of emergency physician in focused cardiac ultrasound evaluations and the success of diagnosing cardiac diseases were evaluated in a patient group presenting to the emergency department with complaints of non-traumatic chest pain and shortness of breath. METHODS: We included patients with complaints of chest pain and shortness of breath and underwent cardiac ultrasound performed by emergency physician. Then, patients were evaluated by a cardiologist. The diagnoses made by the emergency physician were compared with the diagnoses made by the cardiologist. RESULTS: A total of 303 patients were included. The diagnoses made by the emergency medicine specialist and cardiologist as a result of the evaluation were recorded as 56.7% vs 52.10% for acute coronary syndrome, 29.70% vs 31.60% for congestive heart failure, 3.6% vs 3.30% for pulmonary embolism, 2.1% vs 2.10% for hypertensive pulmonary edema, 1.9% vs 2.10% for pericarditis, and 0.60% vs 1.30% for aortic dissection. CONCLUSION: It was determined that focused cardiac ultrasound performed by emergency physician was sufficient in terms of accuracy of findings and diagnosis, and played an important role in excluding or including fatal diagnoses and conditions. The success rates of emergency physician can be further increased with long-term and comprehensive training programs.