Browsing by Author "Koksal, Ozlem"

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The Comparison of Pecarn, Catch, and Chalice Criteria in Children Under the Age of 18 Years With Minor Head Trauma in Emergency Department
(Sage Publications Ltd, 2022) Gizli, Gizem; Durak, Vahide Aslihan; Koksal, Ozlem
Introduction: Minor head traumas constitute a significant part of childhood injuries. The incidence of intracranial pathologies in children with minor head trauma varies in the range of 3%-5%, but it is higher among younger infants. The criteria of the Pediatric Emergency Care Applied Research Network, Canadian Assessment of Tomography for Childhood Head Injury, and Children's Head Injury Algorithm for the Prediction of Important Clinical Events are the most frequently accepted clinical decision-making criteria that were developed for selective computerized tomography requests. This study was conducted to assess the diagnostic performances of the Pediatric Emergency Care Applied Research Network, Canadian Assessment of Tomography for Childhood Head Injury, and Children's Head Injury Algorithm for the Prediction of Important Clinical Events criteria in Turkish society, determine their validity, and find the most suitable algorithm for cranial imaging in children with minor head trauma. Methods: This study retrospectively examined the data of patients under the age of 18 years who were admitted to the Emergency Medicine Department of Uludag University Medical Faculty due to minor head trauma; 530 patients were included as they complied with the criteria. The exclusion criteria were being any trauma patients above the age of 18 years, Glasgow Coma Scale <13, pregnant patients, hemorrhagic diathesis, using anticoagulants, patients with penetrant trauma, patients with priorly known brain tumor, and patients with neurological diseases. The patients were divided into group based on the Pediatric Emergency Care Applied Research Network, Canadian Assessment of Tomography for Childhood Head Injury, and Children's Head Injury Algorithm for the Prediction of Important Clinical Events Criteria. Results: Among all patients, 37.40% were female and 62.60% were male. Abnormal computed tomography findings such as epidural bleeding, subdural bleeding, and skull fractures were detected in 44 of the patients. The sensitivity of the Pediatric Emergency Care Applied Research Network criteria was 72.4%, the specificity was 54.5%, the sensitivity of the Canadian Assessment of Tomography for Childhood Head Injury criteria was 57.8%, the specificity was 50%, the sensitivity of the Children's Head Injury Algorithm for the Prediction of Important Clinical Events criteria was 87.7%, and the specificity was 20%. Conclusion: Given the populations to which the rules apply, it is understood that the Children's Head Injury Algorithm for the Prediction of Important Clinical Events criteria is more determinative in detecting pathological computed tomography outcomes compared to Pediatric Emergency Care Applied Research Network and Canadian Assessment of Tomography for Childhood Head Injury.
Epidemiological Investigation of Patients Admitted to the Emergency Department and Considered as Psychiatric Emergencies
(2024) Gizli, Gizem; Koksal, Ozlem; Kıyak, Ramazan
Amaç: Günümüzde acil servise (AS) başvuran hastaların %3-12 sine psikiyatrik bir ön tanı konulmaktadır. Bu nedenle AS’ de çalışan hekimler psikiyatrik hastalıkları iyi bilmeli ve doğru tedavi algoritmalarını planlayabilmeleri gerekmektedir. Bu çalışmada acil serviste psikiyatrik ön tanı alan hastaların sosyodemografik, etyolojik, epidemiyolojik durumlarını değerlendirmek amaçlanmıştır. Gereç ve Yöntem: Prospektif olarak 16.10.2015-16.01.2016 tarihleri arasında acil servisde psikiyatrik tanı alan 18 yaş üstü hastalar çalışmaya alınmış. Hastaların demografik bilgileri, başvuru şikayetleri, psikiyatrik/fizik muayene bulguları, tıbbi öyküleri, mevcut tanıları, AS’ de aldıkları ön tanılar, laboratuvar ve radyolojik tetkikleri, hastaneye yatış, taburculuk, mortalite/morbidite gibi sonlanma durumları istatistiksel olarak değerlendirilmiştir. Bulgular: Çalışma kriterlerini karşılayan 727 hasta tespit edilmiş, ancak 500 hasta üzerinden analiz yapılmıştır. Hastaların başvuru sırasındaki bulguları sırasıyla; psikotik bulgularla (%68), depresif bulgular %9,8, suisidal bulgular %7,6 ve manik bulgular %6,6 olarak saptandı. Çalışmada hastaların hastaneye yatışı oranı %12,6 olduğu ve %20,6’sının yatışının ise kendi isteği dışında olduğu saptandı. Sonuç: Çalışmamızda Psikiyatrik acillerde, genç-orta yaş ve kadın olmanın hem AS’lere başvuruda hem de hastaneye yatışta risk faktörü olabileceğini düşündürmektedir. Acil Servislerin yoğunluğu ve iş yükü de göz önünde bulundurularak, hastaların fiziksel sağlık sorunlarıyla ilgilenmesinin yanı sıra hastaların ruh sağlığı ihtiyaçlarını değerlendirmek açısından da kritik bir öneme sahip olduğu görülmektedir.