Sepsis is one of the most important causes of morbidity and mortality in patients presenting to the emergency department. SIRS criteria that define sepsis are not specific and do not reflect the severity of infection. We aimed to evaluate the ability of the modified mortality in emergency department sepsis (MEDS) score, the modified early warning score (MEWS) and the Charlson comorbidity index (CCI) to predict prognosis in patients who are diagnosed in sepsis. We prospectively investigated the value of the CCI, MEWS and modified MEDS Score in the prediction of 28-day mortality in patients presenting to the emergency department who were diagnosed with sepsis. 230 patients were enrolled in the study. In these patients, the 5-day mortality was 17 % (n = 40) and the 28-day mortality was 32.2 % (n = 74). A significant difference was found between surviving patients and those who died in terms of their modified MEDS, MEWS and Charlson scores for both 5-day mortality (p < 0.001, p = 0.013 and p = 0.006, respectively) and 28-day mortality (p < 0.001, p = 0.008 and p < 0.001, respectively). The area under the curve (AUC) for the modified MEDS score in terms of 28-day mortality was 0.77. The MEDS score had a greater prognostic value compared to the MEWS and CCI scores. The performance of modified MEDS score was better than that of other scoring systems, in our study. Therefore, we believe that the modified MEDS score can be reliably used for the prediction of mortality in sepsis.

No abstract

Objective: Patients with Renal colic attack are usually admitted to hospital due to single-sided, sharp and sudden localised pain. 90% of patients have haematuria. Some analgesics might be used alone or in combination. This study was conducted to establish the relationship between haematuria severity determined in renal colic patients admitted to the ED and the efficacy of intramuscular (IM) non-steroid analgesic application. Material and Methods:The study was carried out prospectively in the Emergency Department. A total of 87 out of the possible 106 patients were included in the study. Pain severity was measured in accordance with the "Visual Analogue Scale" (VAS). Urine samples from patients were first evaluated macroscopically and then microscopically after being centrifuged to determine Erythrocyte count/hpf (high power field). VAS pain severity of patients who received 75 mg/3 mL Diclofenac sodium IM as an analgesic was measured and recorded at the time of admission; the measurements were repeated 20, 30 and 45 minutes after the analgesic was given. Results: When the score differences were examined between VAS values at the time of admission of patients and at 20, 30, and 45 mins after analgesia, a significantly positive correlation was found between haematuria severity and analgesic efficacy (p=0.003, r=0.311). Conclusion: If there is intensive or red colour anamnesis in patients presenting to the ED who are likely to be diagnosed as renal colic, the initial application of IM non-steroid analgesic may provide better pain palliation and increase patient comfort. (JAEM 2013; 12: 195-8)