Background This study aimed to analyze patients who apply to emergency services and need palliative care regarding appropriate patient care and effective use of health institutions. Materials and Methods The study was conducted prospectively on patients who applied to the emergency services of Bursa Uludag University Health Application and Research Center, Health Sciences University Bursa Yüksek Ihtisas Training and Research Hospital and Bursa City Hospital between 15.08.2021 and 15.02.2022 and needed palliative care. Results A total of 261 patients, 143 male (54.8%) and 118 female (45.2%), were included in the study. It was determined that 50 (19.1%) of these patients had previously received palliative care services. It was determined that the patients included in the study applied to the emergency services 7.52±6.77 times in the last year. The three most common diseases diagnosed in patients admitted to the emergency department were pneumonia (24.5%), urinary system infection (7.7%), and cerebrovascular disease (5.4%). Of the patients, 39.84% were referred/hospitalized, 25.28% were referred/hospitalized to intensive care units, 2.68% refused treatment, 2.68% died, and 29.5% have been discharged. Conclusion As a result, it is understood that most of the patients in need of palliative care do not receive this service, and patients who can be treated in palliative care units are treated in clinics and intensive care units.

Objectives: The aim of our study is to investigate the efficacy of D-dimer marker in patients who applied to the emergency department with a preliminary diagnosis of pulmonary embolism. Study Design: Retrospective study. Methods: This study was conducted retrospectively at Bursa Uludağ University Faculty of Medicine Hospital between January 2018 and December 2018. Patients whose D-dimer levels were checked considering the preliminary diagnosis of pulmonary embolism were included in the study. Results: A total of 3411 patients were included in the study. In all patients, the diagnosis of PE was made by computed tomography pulmonary angiography. Examination of 1968 patients with (+) D-dimer revealed new diagnosis in 702 patients (35.67%). Pulmonary embolism was diagnosed in a total of 74 patients (10.54%) whereas the most common alternative diagnoses was 33.62% (n=236) pneumonia. On examination of 1443 patients with negative D-dimer levels, pulmonary embolism was diagnosed in 7 (3.14%) patients whereas the most common other diagnoses was 44.84% (n=100) Acute Coronary Syndrome. However, in the D-dimer positive patient group, the rate of newly diagnosed patients requiring clinical and intensive care hospitalization was found to be significantly higher. Conclusion: In conclusion, even if pulmonary embolism is not detected in D-dimer positive cases, it is thought that these patients need further investigation, considering the frequency of serious conditions requiring clinical and intensive care unit admission.

Background This study aimed to retrospectively examine the morbidity and mortality rates after discharge of patients who applied to the emergency department with high D-dimer values but had no pathology upon evaluation. Material and Methods Patients over the age of 18 who applied to Bursa Uludağ University Faculty of Medicine Emergency Department with preliminary diagnosis of pulmonary embolism in a two-year period between January 2018 and December 2019 were included in the study. The patient group consisted of cases with high D-dimer levels while the control group inluded patients with negative D-dimer and no pathology on discharge. Results A total of 594 cases; 297 D-dimer positive (+) and 297 D-dimer negative (-), were included in the study. A significant difference existed between the percentage of patients developing illness post-discharge in the D-dimer (+) 18.86% (n=56) and D-dimer (-) 1.68% (n=5) groups, respectively. The most common illness identified in the dimer (+) group after discharge up was pneumonia (n=11), followed by Coronary Artery Disease (n=5). Death rate was 1.68% (n=5) in the D-dimer (-) group and 11.78% (n=35) in the D-dimer (+) group; a statistically significant difference (p=0.001). Conclusions In conclusion, both morbidity and mortality rates were found to be significantly higher in the D-dimer positive group.