Earthquake victims in focus: a cross-sectional examination of trauma and management in intensive care unit.

BACKGROUND: After the Kahramanmaras earthquake of February 6, 2023, the disaster of the century, a significant number of victims were admitted to intensive care units (ICUs). In this study, we aimed to share the characteristics and management of critical earthquake victims and shed light on our experiences as intensivists in future earthquakes. METHODS: The study included 62 earthquake victims in two tertiary ICUs. Demographic characteristics, laboratory findings, clinical characteristics, trauma and disease severity scores, treatments administered to patients, and the clinical course of the patients were recorded retrospectively. The patients were divided into two groups, survivors and nonsurvivors, according to 7-day mortality and into two groups according to the duration of their stay under the rubble: those who remained under the rubble for 72 hours or less and those who remained under the rubble for more than 72 hours. A receiver operating characteristic (ROC) curve analysis was used to determine the best cutoff value for the 'Circulation, Respiration, Abdomen, Motor, and Speech' (CRAMS) score. RESULTS: The median age of the 62 patients included in the study was 35.5 (23-53) years. The median length of stay under the rubble for the patients was 30.5 (12-64.5) hours. The patient was transferred to the ward with a maximum duration of 222 hours under the rubble. The limb (75.8%) was the most common location of trauma in patients admitted to the ICU. Crush syndrome developed in 96.8% of the patients. There was a positive correlation between the development of acute kidney injury (AKI) and myoglobin, serum lactate, and uric acid levels (r = 0.372, p = 0.003; r = 0.307, p = 0.016; r = 0.428, p = 0.001, respectively). The best cutoff of the CRAMS score to predict in-7-day mortality was < 4.5 with 0.94 area under the curve (AUC); application of this threshold resulted in 75% sensitivity and 96.3% specificity. CONCLUSION: Search and rescue operations should continue for at least ten days after an earthquake. The CRAMS score can be used to assess trauma severity and predict mortality in critically ill earthquake victims.

Smoking Cessation Success and Affecting Factors in Geriatric Patients.

Background: There are difficulties in the treatment of smoking cessation in elderly patients. However, elderly smokers who gave up smoking had lower rates of death from heart attack, stroke, and cancer, as well as improved cognitive function. This study aimed to investigate the affecting factors and the success of smoking cessation rate in patients aged 60 and over in Turkey. Methods: Six smoking cessation outpatient clinics from four provinces were included in the study. The records of 1,065 patients who applied to a smoking cessation outpatient clinic between 2016 and 2019 and who were 60 yr of age or older were scanned. Overall, 917 cases that could be reached after treatment were included in the study. Smoking cessation rates at the first month, 3rd month, 6th month, 9th month and 12th month were given. Results: Of the 917 cases, 65.1% were male and 34.9% were female. Smoking cessation rates were 45.6% on the first month, 39% on the third month, 35.1% on the sixth month, 31.2% on the ninth month, and 30.3% at the twelfth month. Smoking cessation success was higher in men than in women. Conclusion: Since the success of smoking cessation in the elderly was similar to that of adults. Since smoking is an independent risk factor for death in the elderly, there should be greater willingness to provide elderly patients with smoking cessation treatment to reduce physical function loss and promote healthier aging.

Compliance With the Legislation of the Smoking Cessation Clinic in Turkey.

OBJECTIVES: The number of smoking cessation outpatient clinics (SCCs) is increasing day by day in Turkey. The objective of this study is to evaluate the situation of smoking cessation clinics in our country. MATERIALS AND METHODS: The SCC list was obtained from the website of the Ministry of Health of the Republic of Turkey. A total of 305 centers from 80 cities were called by telephone, and a questionnaire including questions about polyclinics was directed to SCC employees whose verbal consent was obtained. RESULTS: Of the 305 SCCs, 183 could be reached, 33 of which did not provide outpatient services. A questionnaire was directed to 146 SCCs. A total of 347 doctors work in these centers. Of these 146 SCCs, 69 (47.3%) accepted patients with appointments and 77 (52.7%) accepted patients directly. The specializations of physicians in the SCCs were as follows: 84 (57.5%) were chest disease specialists, 30 (20.5%) were general practitioners, 10 (6.8%) were psychiatrists, 12 (8.2%) were other branch physicians, 6 (4.1%) were family physicians, and 3 (2.1%) were public health physicians. A total of 125 (85.6%) physicians working in SCCs received smoking cessation training. Only 35 (24%) SCCs have one or more provincial tobacco control members. Eighty (54.8%) SCCs had a separate SCC room, 74 (50.7%) had a waiting room for the patients, and 63 (43.2%) had a carbon monoxide (CO) measurement device in the SCC. CONCLUSION: All physicians in Turkey are able to provide smoking cessation services, but the chest physicians are mostly responsible for this task. In addition to increasing the number of SCCs, it is very important to increase the quality and comply with the standards.