Performance of integrated pulmonary index for pulmonary embolism in dyspneic patients.

OBJECTIVES: The aim of this study was to evaluate the diagnostic capacity of integrated pulmonary index (IPI) in predicting the pulmonary embolism (PE) in patients admitted to emergency departments (ED) with dyspnea. BACKGROUND: The acute dyspnea is one of the most common chief complaints in EDs. PE is a potentially fatal disease and the delay in specific therapy increases the worst outcomes. METHODS: This study is a prospective methodological study, in which we evaluated the diagnostic performance of the IPI in predicting PE in patients admitted to ED with dyspnea. ROC analysis was used for estimating the accuracy of IPI and OCRS. RESULTS: Of the 144 patients included in the study, there were 20 (13.9 %) PE patients. In the ROC analysis, the best cut-off point for IPI was ≤ 2. For this cut-off point, the sensitivity and specificity of IPI were 100.0 % and 96.0 %, respectively. Besides, the accuracy of IPI was 96.5 % with a +LR of 24.8 and a -LR of 0.0. CONCLUSION: IPI was a potential candidate for evaluating the respiratory status, and a limiting tool to prevent unnecessary diagnostic tests and save time in determining the treatment course in dyspneic patients at ED (Tab. 5, Fig. 3, Ref. 34).

Carbon monoxide intoxication in geriatric patients: How important are lactate values at admission?

PURPOSE: The aim of this study was to investigate the demographic and clinical characteristics and treatment modalities of elderly patients with carbon monoxide (CO) intoxication. The secondary aim was to evaluate the importance of plasma lactate values in the diagnosis of acute CO intoxication in geriatric patients. METHODS: Data on geriatric patients who were admitted to the emergency department of Atatürk University Medical Faculty between January 2013 and April 2016 were analyzed retrospectively. RESULTS: Of the 197 cases included in the study, 97 were in the intoxication group and 100 were in the control group; 82.5% of the intoxication cases had mild neurological symptoms and 17.5% had severe neurological symptoms. Carboxyhemoglobin levels were significantly higher in patients with severe neurological symptoms (p = 0.031). All patients with severe neurological symptoms received hyperbaric-oxygen therapy (p < 0.001). In the intoxication group, lactate levels were significantly higher than in the control group (p = 0.001). The specificity for lactate 4 mmol/L and above was found as 98.0% with a positive predictive value and negative predictive value of 84.5% and 53.3%, respectively. CONCLUSION: High initial lactate levels may be a guide for cases with nonspecific symptoms in geriatric patients with suspected CO intoxication.