The aim of the study was to analyze the usefulness of CURB-65 and the pneumonia severity index (PSI) in predicting 30-day mortality in patients with COVID-19, and to identify other factors associated with higher mortality. Methods: A retrospective study was performed in a pandemic hospital in Istanbul, Turkey, which included 681 laboratory-confirmed patients with COVID-19. Data on characteristics, vital signs, and laboratory parameters were recorded from electronic medical records. Receiver operating characteristic analysis was used to quantify the discriminatory abilities of the prognostic scales. Univariate and multivariate logistic regression analyses were performed to identify other predictors of mortality. Results: Higher CRP levels were associated with an increased risk for mortality (OR: 1.015, 95% CI: 1.008-1.021; p < 0.001). The PSI performed significantly better than CURB-65 (AUC: 0.91, 95% CI: 0.88-0.93 vs AUC: 0.88, 95% CI: 0.85-0.90; p = 0.01), and the addition of CRP levels to PSI did not improve the performance of PSI in predicting mortality (AUC: 0.91, 95% CI: 0.88-0.93 vs AUC: 0.92, 95% CI: 0.89-0.94; p = 0.29). Conclusion:In a large group of hospitalized patients with COVID-19, we found that PSI performed better than CURB-65 in predicting mortality. Adding CRP levels to PSI did not improve the 30-day mortality prediction.
AMAÇBu çalışmada, ürogenital bölgeyle ilişkili travma nedeniyle acil servise başvuran hastaların özellikleri, morbidite ve mortalite ile ilişkili durumların belirlenmesi amaç-landı. GEREÇ VE YÖNTEMBu prospektif, kesitsel tanımlayıcı çalışmada, ürogenital bölgeyle ilişkili travması olan hastaların demografik özel-likleri, travma şekilleri, inceleme sonuçları, yatış işlemle-ri ve sonuçları değerlendirildi. Çalışmaya toplam 153 majör travması olan hasta [108 erkek (%70,6); 45 (%29,4) kadın] alındı. BULGULAROlguların 23'ü (%15,03) penetran, 130'u (%84,96) künt travmalı idi. Oluş nedeni hastaların 79'unda trafik kazası, 42'sinde yüksekten düşme, 12'sinde ateşli silah yaralanması ve 10'unda delici-kesici alet yaralanması idi. Hastaların 60'ında pelvis kırığı, 35'inde böbrek, 4'ünde mesane yaralanması saptandı. Hastaların 21'i herhangi bir nedenle ameliyat edildi. Hastaların 17'si öldü. Hematüri varlığı ile böbrek yaralanması arasında anlamlı ilişki saptandı. SONUÇÜrogenital yaralanmalar sıklıkla diğer organ yaralanmalarıyla birliktedir ve kaybedilen hastaların ölüm nedenleri genellikle diğer organ yaralanmalarına bağlıdır. Ayrıntılı klinik değerlendirme ile zamanında tanı konulup girişimde bulunulması ürogenital bölge yaralanmalarına bağlı ölüm olaylarını önlemede önemlidir.
Background The clinical spectrum of COVID-19 has a great variation from asymptomatic infection to acute respiratory distress syndrome and eventually death. The mortality rates vary across the countries probably due to the heterogeneity in study characteristics and patient cohorts as well as treatment strategies. Therefore, we aimed to summarize the clinical characteristics and outcomes of adult patients hospitalized with laboratory-confirmed COVID-19 pneumonia in Istanbul, Turkey. Methods A total of 722 adult patients with laboratory-confirmed COVID-19 pneumonia were analyzed in this single-center retrospective study between March 15 and May 1, 2020. Results A total of 722 laboratory-confirmed patients with COVID-19 pneumonia were included in the study. There were 235 (32.5%) elderly patients and 487 (67.5%) non-elderly patients. The most common comorbidities were hypertension (251 [34.8%]), diabetes mellitus (198 [27.4%]), and ischemic heart disease (66 [9.1%]). The most common symptoms were cough (512 [70.9%]), followed by fever (226 [31.3%]), and shortness of breath (201 [27.8%]). Lymphocytopenia was present in 29.7% of the patients, leukopenia in 12.2%, and elevated CRP in 48.8%. By the end of May 20, 648 (89.7%) patients had been discharged and 60 (8.5%) patients had died. According to our study, while our overall mortality rate was 8.5%, this rate was 14.5% in elderly patients, and the difference was significant. Conclusions This case series provides characteristics and outcomes of sequentially adult patients hospitalized with laboratory-confirmed COVID-19 pneumonia in Turkey.
Aim: Suicidal behavior is defined as choosing death in the conflict between life and death. The aim of this study is to investigate the suspected relationship between suicide attempts and menstrual cycles and to evaluate the sociodemographic and clinical characteristics of the non-pregnant female patients of reproductive age who have presented to our hospital after attempting suicide. Materials and Methods:In this study, 102 female patients (aging 16-45 years) of reproductive age with regular menstrual cycles who presented to the emergency department because of suicide attempts were enrolled. The study was designed as prospective, cross-sectional, and descriptive. The patients' sociodemographic, clinical, and laboratory biochemical parameters were recorded. For the purposes of this study, 100 healthy women who fulfilled the criteria formed the control group and underwent the same procedures as the patient group.Results: Among the patients who presented to the hospital after attempting suicide, 64 (62.7%) were in their menstrual period, six (5.9%) were outside their menstrual period during the follicular phase, five (4.9%) were at the mid-cycle peak, and 27 (26.4%) were at the luteal phase, as determined on the basis of the date of their last menstrual period and their blood hormone levels. Conclusion:The majority of suicide attempts by women occurred during their menstrual period when the estradiol and progesterone levels are at their lowest. (Eurasian J Emerg Med 2015; 14: 118-22)
OBJECTIVE:The objectives of this study were to identify predictors of mortality in young adult patients with coronavirus disease 2019 and to assess the link between blood type and mortality in those patients. METHODS: This multicenter retrospective study, which was conducted in seven training and research hospitals in Istanbul, involved young adults who aged ≥18 and <50 years and hospitalized with coronavirus disease 2019. RESULTS: Among 1,120 patients, confusion at admission (p<0.001) and oxygen saturation (p<0.001) were significantly predictive factors of mortality. Blood type O was significantly associated with mortality compared to those discharged from the hospital (p<0.001). Among co-morbidities, the most reliable predictive factors were cerebral vascular disease (p<0.001) and chronic renal failure (p=0.010). Among laboratory parameters, high C-reactive protein (p<0.001) and low albumin (p<0.001) levels were predictors of mortality in young adult patients with coronavirus disease 2019. CONCLUSIONS: SpO 2 at admission was the best predictor of mortality in young adult patients with coronavirus disease 2019. The mortality rate was increased by cerebral vascular disease and chronic renal failure. Also, high C-reactive protein and low albumin levels were predictive factors of mortality. Moreover, blood type O was associated with a higher mortality rate than the other types.
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